CHORIONIC VILLI SAMPLING
INTRODUCTION:-
Chorionic villi sampling is the prenatal diagnostic technique in which tissue for genetic
or chromosomal analysis is aspirated from the chorionic frondosum under ultrasonic
guidance before 14 weeks of gestation.
It can be transabdominal or transvaginal.
INDICATIONS FOR CVS:-
Chorionic villus sampling has the advantage of yielding a larger amount of tissue and allow rapid
karyoptying within 24-48 hours.
1. Previous autosomal trisomic fetus
2. Previous fetus with triple X (47, XXX) or Klinefelter’s syndrome (47, XXY)
3. Woman or partner has a chromosomal translocation or are carriers of chromosomal
inversions.
4. X-linked recessive disorders
5. Mendelian disorders
6. History of triploidy in the fetus in the past.
7. Repeated first trimester abortions.
The sample may be sent for the following analyses:
1. DNA analysis for hemoglobinopathies; Duchenne muscular dystrophy, cystic fibrosis,
alpha-1- antitrypsin deficiency.
2. Chromosomal abnormalities
3. Inborn errors of metabolism
COMPLICATIONS:-
A. Fetal loss rate: Fetal loss rate is slightly higher with CVS (0.5%)than with
amniocentesis.
B. Limb reduction defects, especially if done before 10 weeks of gestation.
C. Placental mosaicisms can occur in about 1.5% cases needing further invasive testing to
obtain fetal cells.
D. Spontaneous rupture of membranes can occur in less than 0.5% of the procedures and
can cause oligohydramnios and spontaneous abortion.
E. Intrauterine infections: The incidence ranges between 0.2-0.5%, usually following
transcervical procedures.
PROCEDURE:-
Two ways
1. Transcervical
2. Transabdominal
• Preparation of the patient
• An abdominal ultrasound is performed to determine the position of the uterus, the size of the
gestational sac, and the position of the placenta within the uterus. vulva, vagina, cervix, and
abdomen are cleaned with an antiseptic
TRANSCERVICAL
It is performed by inserting a thin plastic tube through vagina & cervix to reach placenta with the
help of ultrasound guided images
• 10 weeks to 12 weeks
TRANSABDOMINAL
• It is performed by inserting a needle through the abdomen utreus to reach placenta with
the help of ultrasound guided images
• 10 weeks to term
• Sample collected are sent to lab for direct preparation and culture in special fluids
• The sample is used to study the DNA , chromosomes, and certain signs (called chemical
markers) of disease in the developing baby.
• It can be done sooner than amniocentesis, about 10 to 12 weeks after last menstrual
period.
• Test results take about 2 weeks.
RESULTS:-
• Normal Results
A normal result means there are no signs of any genetic defects.
• Abnormal Results
• Down syndrome
• Hemoglobinopathies- sickle cell anemia
• Tay-Sachs disease
• sex linked disorders – muscular dystrophy More than 200 gentic disorder can be
identified
• Flase positive – placental mosaics
• maternal cell contamination
• It does not detect Neural tube defects Rh incompatibility Congenital defects
• It is also useful in determining paternity of a child prior to delivery
RISKS:-
• Miscarriage 1:100
• Infection
• Spotting
• Cramping and pain at puncture point
• Bleeding
• Rupture of membrane
• Limb reduction defects (LRD) when performed at <9 weeks
CONTRAINDICATINS:-
• Women who Have an active infection(STD) Carrying twins
• Have experienced vaginal bleeding during pregnancy
• Having uterine fibroids
• Having tilted uterus
BIBLIOGRAPHY:-
Swain Dharitri. Obstetrics nursing procedure manual. Jaypee the health sciences
publisher:New Delhi;2017. Pg.No. 141-145.
Jacob Annamma, R Rekha. Clinical nursing procedures: The art of nursing practice. 2 nd edition.
Jaypee publisher: New Delhi; 2010.Pg. No. 180-183.
