Amniocentesis and CVS - AmniocentesisandCVS...

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    Amniocentesis and CVS Dr. Joseph Har-Toov Lis Maternity Hospital Tel-Aviv, Israel
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Methods of chromosomal evaluation Non invasive: Fetal cells from maternal blood  preimplantation embryos (PGD) Invasive: amniotic fluid (amniocentesis) placenta (chorionic villus tissue)  Fetal blood 
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Invasive techniques Amniocentesis: Late – second trimester after 15 weeks Early – earlier than 15 weeks Chorionic villus sampling (CVS)  Abdominal Trans cervical Trans vaginal Fetal blood sampling
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karyotype fish PCR
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What can be evaluated? Chromosomal aberrations: Trisomy,  Monosomy,  Polyploidy,  Marker chromosome,  Deletion, duplication, inversion, translocation, ring  chromosome .   Genetic aberrations (DNA) Infectious disease Biochemical markers (AFP)
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Amniocentesis First introduced by Serr and Fuchs and Riis in  the 1950s for fetal sex determination Only at the late 70 th  a static ultrasound was used  to locate the placenta and amniotic fluid pocket Only  In 1983, Jeanty reported a technique of  amniocentesis ’’under ultrasound vision’’
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Mid Trimester Amniocentesis Per coetaneous  20-23g needle Ultrasound guided Usually 20cc amniotic fluid Results – 2 to 3 weeks 
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complications Pregnancy loss  0.3-1.0%.  Increase risk: Needle larger than 18g Multiple needle insertion Discoloration of the fluid High AFP, multiple late abortions, previous vaginal  bleeding  Placental perforation – recent studies didn’t find  correlation
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Complications Leakage of amniotic fluid (better prognosis than  spontaneous leakage) Amnionitis Vaginal bleeding  Needle puncture of the fetus Long term complications: Respiratory distress??
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  • Fall '11
  • Dr.Aslam
  • vaginal bleeding, Respiratory distress, Turner syndrome, amniotic fluid, Lis Maternity Hospital, Dr. Joseph Har­Toov

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