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Hello, Firstly, Congratulations on your pregnancy! And about CVS...You will only be offered CVS if after your prenatal screening tests they find the Nuchal Translucency is elevated and you are considered screen positive. Otherwise, it would not be necessary. Yes, CVS (chronic villus sampling) does give a more accurate result for chromosonal problems like DS, Trisomy and open neural defects. I was offered CVS on my last pregnancy in Dec'05 because I had a 4.0 measurement and this was considered high as it was over 3.0. Any reading under 3.0 is considered normal. The reason they do CVS between 11- and 13 weeks 6 days is because if there would be a chance you would terminate the pregnancy if there were problems than early detection is a better option, you would not have to wait for the amnio to find out if there were any problems at 16-18weeks and then you after that point you would have to be induced. The miscarriage rate is slightly higher than with that of amnio...but it often depends on the capabilities of the doctor performing the CVS. If prenatal tests come back screen positive you may be offered CVS..otherwise..there should be no need. I am in Canada and we have 2 parts to our prenatal screening tests with the first part done at 11-13 weeks and the second at 16-18weeks. I am 18 weeks and I will find out the results of my screening tests part 1 and 2 tomorrow. I also have an ultrasound next week. I wish you all the best..and remember the blood test and ultrasound are indeed an indicators and CVS and amnio do give more definitive results..but unless the doctors feel it is absolutely necessary I personally would opt out of these tests uless I advised by my doctors to do them. All the best!! Kristin

Being AMA (advanced maternal age, a.k.a. over 35) sucks. There are just so many more things to consider, like genetic testing. I don't envy you having to go through this stage, it was the worse part of my pregnancy. I'm 24 weeks now. Things are apparently different here in California than Canada as I was given the option of CVS or early Amniocentesis right off the bat. Course, my hospital didn't offer the 1st trimester screening (nuchal translucency U/S & blood work) so that may be why. However, I went outside my hospital and had it performed. My odds of delivering a baby with Down Syndrome went from 1:255 to 1:7000 and even better for Trisomy 18. My dh and I decided not to risk an Amnio (it was too late for CVS). Things you should keep in mind: At 43, your odds of delivering a baby with DS is approximately 1:53. The 1st trimester screening is only a screening to estimate your risks and it is only 80% accurate, meaning there is a 20% chance you could get a false negative. The 1st Trimester Combined Screening which Kristin had done increases the accuracy to 90%. Both CVS & Amniocentesis are invasive diagnostic tests that will definitely tell you if your baby has a chromosomal defect, but there is a risk of miscarriage, 1% for CVS and 0.5% for Amniocentesis. Also, CVS will not detect neural tube defects such as spina bifida. If you have a CVS, it is recommended that you follow up with the Triple Screen, a.k.a. Multiple Marker Screen, a.k.a. Expanded AFP Screen, between 15-20 weeks to a__sess your risk for neural tube defects. Congratulations on your pregnancy. I wish you the best of luck through worrisome stage.

Hello K8T, congratulations! I'll be 38 when baby is born and was offered the option of First Trimester Screening (u/s & blood test) and/or CVS or Amnio. To answer your questions, no, I did not opt to do CVS or amnio. I opted for just the ultrasound and blood test. After hearing that my odds for down syndrome and trisomies were vastly improved based on the u/s and bloodtest I saw no reason to do the CVS or the amnio. At first, I briefly considered skipping the ultrasound and bloodtest and going directly to the amnio but decided against the less accurate but also less invasing First Trimester Screening followed up with AFP testing mentioned by CaliTrish. Deciding which tests to opt for is a troubling and tough choice to make. It's a highly personal choice but for me although it was important to know if my baby had an abnormality, I did not want to know at the risk of having another miscarriage. Some women decide to do no testing at all and others want the most accurate information possible---like I said it's such a personal and tough decision to make. I wish you luck in whichever choice you make and hope for great results!!

thanks for all your input it really helps....just one questions for Kristin....do you have to wait until you are 18 weeks to find out the results of the screening part 1 that you had 6 weeks prior? Can't they give you any info before then? If CVS testing can only be done between 11 and 13 weeks...then wouldn't it be too late?

I would really recommend getting the CVS test done. I've had it twice with both of my pregnancies with no issues. In my first pregnancy the baby was diagnosed with trisomy 13, which is a devastating chromosomal problem. It was a horrible thing to go through, however it would had devastating if I found out later in my pregnancy.

Thanks Karyn....but I'm not sure I can just get it done without going through the prescreening first..I'm in Ontario Canada....are you in the US?

I am given the results of the NT which was 1.4 and the CRL which was within normal range and they do a prelimary evalution if there were any red flags like elevated protein or glucose...I would have been notified. Like I was last time. I had been told right away (within 2 days of the test that I tested screen positive) and I was wisked off to a geneticist and a councellor for genetics. I was then given the option to go for CVS. The combined bloodwork and urine a___lysis part 1 and 2..just makes for a more accurate reading and the one of test does not test for open neural tube defects... the only thing they did not give me until now was the odds of DS,Trisomy, and open neural tube defects..Today I found out I a 1:18,000. What a relief. Hope this helps ibk8t. Kristin

I made my decisions re testing, decided to do it in stages, if the nuchal translucency test was good was not going for cvs (it was excellent, 1.4mm about as low as you can go) so opted out of further testing. If i had to go for invasive testing would rather it earlier than later, ie, cvs over amnio. Did not go for triple screen as at age 45 the results would not be reliable, age alone would skew them. Also ibk8t i dont know if you would have to have pre-screening, at over forty you are considered 'high risk' so i would think you are automatically ent_tled to what ever testing is available. Good luck with your pregnancy.

Congratulations, Kristin!!! 1:18,000 is wonderful. Breathe a deep sigh of relief and enjoy the rest of your pregnancy!

ibk8t- yes I live in the US. If you're over 35 you don't need any advanced screening to get CVS. Since insurance covered it and I was able to know the results early on in the pregnancy, it was a no brainer. I also live in a large metropolitan city and as a result was able to obtain a specialist for the proceedure. The nice thing about CVS is that you know right away if there is an issue. I think I would have been a nervous wrek with this pregnancy (29 weeks now) if I had to wait until mid way through the 2nd trimester to find out the baby was alright. After my last experience I was terrified of any major problems.

I am going to agree with everyone, I had a CVS done with my last 2 (over 35) pregnancies and I did not have or need any pre-screening done. In fact I was told that it is not recommended for those over 35. The first one went great, this one, however, I had done at 11 1/2 wks and it came back showing a disease I had never even considered. mosaic Turner's Syndrome. Because of that, I had to go back and do an amnio, which I had done yest at 15 wks, to see if it affects the baby as well. There are times, apparently, that what the placenta has, the baby doesn't necessarily. Here is a good website to review that. http://www.medgen.ubc.ca/wrobinson/mosaic/cpm.htm (if any show up, there are no dashes in that site addie) Anyway, the spinda bifida is determined by blood test as well so that is no big deal. As with any procedure, there is always a risk but many times m/c's happen because they would have anyway. Not always, but many times. So good luck too you. Also, it took about 2 weeks for results.