Government College of Nursing Jodhpur (Raj.)

GOVERNMENT COLLEGE OF
NURSING
JODHPUR (RAJ.)
Procedure
On-
CHORIONIC VILLI SAMPLING
Subject-Obstetrics & Gynecology Specialty-I
SUBMITTED TO - SUBMITTED BY-

Mrs. ANNAMA SUMON NAJISH ANSARI
NURSING LECTURER M.sc (N) Pre. year
GCON, Jodhpur GCON, Jodhpur
CHORIONIC VILLI SAMPLING
INTRODUCTION
Chorionic villus sampling (CVS) is prenatal diagnostic procedure to detect certain fetal genetic
abnormalities. Both procedures increase the risk for miscarriage. In addition, concern has been increasing
among health care providers and public health officials about the potential occurrence of birth defect
resulting from CVS.
This report describes CVS and amniocentesis, provides information on indications for their use, reviews
studies about the safety of the procedure, compare the benefits and risks of the two procedures (focusing
particularly on the risk for limb deficiency after CVS), and provides recommendations for counseling about
these issues. A public meeting was converted on March11, 1994, to discuss the result of studies of CVS-
associated limb deficiencies and preliminary counseling recommendations that had been drafted at CDC.
Participants included geneticists, obstetricians, pediatricians, epidemiologists, dermatologists,
dysmorphologists, and genetic counselors who had a particular interest in CVS studies or who represented
professional organizations and government agencies. Participants provided diverse opinions about
recommendations for counseling both at the meeting and in subsequent written correspondence, input from
participants has been incorporated into this document.
Chorionic villus sampling (CVS) is a test that check the pregnancy for genetic abnormalities.
The pregnancy can be tested by taking a small sample of the developing placenta.The sample is collected
using a slender needle which is inserted through women abdomen and into the placental tissues. The tissues
(Chorionic villi) is then examined in a laboratory.
It is commonly performed between 10 and 12 weeks of pregnancy.
DEFINITION: -
Chorionic villus sampling (CVS) is prenatal test in which a sample of chorionic villi is removed from the
placenta for testing.
During pregnancy, the placenta provides oxygen and nutrients to the growing bod and removes waste
products from the baby’s blood. The chorionic villi are wispy projections that make up most of the placenta
and share the baby’s genetic makeup.
Chorionic villus sampling can reveal whether a baby has a chromosomal abnormality, such as Down
syndrome. It can also be used to test for other genetic disorders, such as Tay- sachs disease and
cysticfibrosis.
Although chorionic villi sampling can provide valuable information about women baby health, the decision
to pursue invasive diagnostic testing is serious. It’s important to understand the risks of Chorionic villus
sampling – and be prepared for the results.
PURPOSE
Chorionic villi sampling can provide information about women baby genetic makeup. Generally, Chorionic
villi sampling is offered when the test results may have a significant impact on management of the
pregnancy- or women desire to continue the pregnancy. Typically, the value of this information can be
assessed only by women and women partner.
Chorionic villi sampling is usually done between 10th and 12th week of pregnancy- earlier than other prenatal
diagnostic tests, such as amniocentesis.
INDICATIONS-
 Women had abnormal results from a prenatal screening test.
 Women had a chromosomal abnormality in a previous pregnancy.
 Women’s age 35 or older.
 Women have a family history of a specific genetic disorder, or women or women partner is a known
carrier of a genetic disorder.
NOTE
Chorionic villi sampling cannot detect neural tube defects, such as spina bifida. If neural tube defects are a
concern, an ultrasound or genetic amniocentesis may be recommended instead.
PRENATAL DIAGNOSIS
Chorionic villi sampling
Time Transcervical 10-12 weeks,
Transabdominal 10 weeks to term.
Material for study Trophoblast cells
Karyotype result Direct preparation-24-48 hrs.
Culture-10-14 days
Fetal loss 1-2%
Accuracy Accurate, may need amniocentesis for confirmation
Termination of pregnancy when indicated 1st trimester safe
Maternal effects following termination of Very little
pregnancy
RISKS: -
Chorionic villi sampling carries various risks, including;
 Miscarriage- Overall, Chorionic villi sampling carries a 1 in 100 risks of miscarriage. The risk of
miscarriage appears to be slightly higher when the tissue sample is taken through the
cervix(Transcervical) rather than the abdominal wall (Transabdominal). The risk of miscarriage also
increases if the baby is smaller than normal for his or her gestational age.
 Cramping and vaginal bleeding- Women may feel cramping during and after the test. Vaginal
bleeding is also being possible, especially if the cell sample was taken through women cervix rather
than abdominal wall.
 Rh sensitization- It may cause some of the baby blood cells to enter of women bloodstream. If
women have Rh negative blood, women will be given a drug called Rh immunoglobulin after the test
to prevent women from producing antibodies against women baby’s blood cells.
 Infection- Rarely, Chorionic villi sampling may trigger a uterine infection.
Some older studies suggested that Chorionic villi sampling may cause defect in a baby’s fingers or toes.
However, the risk appears to be a concern only if the procedure is done before the 9th month of pregnancy.
Remember, Chorionic villi sampling is typically offered when the test results may have a significant impact
on the management of the pregnancy. Ultimately, the decision to have chorionic villus sampling is up to
women. Women health care provider or genetic counselor can help women all the factors in the decision.
PREPARATION FOR CVS: -

 Before Chorionic villi sampling, women can eat as usual.
 Women may need to have a full bladder for the procedure, so drink plenty of fluids before women
appointment.
 Depending on the placental position, women may be asked to empty bladder just before the
procedure. Women health care provider may ask women to sign a consent form before the procedure
begins.
 Women may want to ask someone to accompany women to the appointment for the emotional
support or to drive women afterward.
 First women will have an ultrasound scan to check there is only one baby and to confirm the age of
the baby and the position of the placenta.
 After women abdomen is cleaned with antiseptic solution, the CVS site is injected with local
anesthesia.
 A slender needle is inserted through women abdominal wall until it reaches the placenta.
 The path of the needle is followed carefully on the ultrasound screen.
 A finer needle is threaded through the 1st needle, and a syringe on the end of the fine needle is used
to draw up very small fragments of the placental tissues.
 The tissue is examined to make sure that it is the right kind of the tissues and samples are taken until
there is enough to perform the test. This takes about 2 minutes or so.
 Women may feel a strange dragging or drawing sensation in women pelvis- this is normal, and no
cause for alarm.
 Once the sample is taken, the needle is removed and the baby is checked again using the ultrasound
scan.
 Women can leave the room immediately to get dressed. After sitting quietly for 30 minutes or so
women may go home.
 While most women are quite capable of driving themselves, where possible it is suggested that
someone accompany women so that women can be driven home, women normally recommend that
women take it quietly for the rest of the day and possibly the next day as women, although there is
no reason to go to bed.
 The placental sample is sent to a laboratory and grown in culture. When enough cells have grown,
the chromosomes are individually examined to make sure the number, appearance and size are
correct. The results are usually sent to women doctors within two weeks.
RESULTS
Women health care provider or a genetic counselor will help women understand women Chorionic villi
sampling results.
Most test result are normal, which can ease anxiety about women baby’s health. Occasionally, test results
are unclear and amniocentesis is needed to clarify the diagnosis.
With Chorionic villus sampling, there’s rare chance of a false- positive test-when the test is positive, but no
diseases exists.
It’s also important to remember that Chorionic villi sampling can’t identify all birth defects, including spina
bifida and other neural tube defects.
If Chorionic villi sampling indicates that women baby has a chromosomal problem or a genetic disorder that
can’t be treated, women may be faced with wrenching decisions- such as whether to continue the pregnancy.
Seek support from women health care team and women loved ones during this difficult time.
Nurse’s Role in CVS

 Explain the purposes of procedure and how it will be done.
 Advise for drink lots of water so that full bladder to capture clearer images.
 Provide privacy.
 Provide supine position.
 The abdominal wall is prepared and draped.
 Check USG.
 Fetus should be monitored for short period after procedure, check FHR every 30 minutes.
 Tell patient, to report physician if uterine cramping, vaginal bleeding or leakage of fluid or fever.
 Strenuous activities should be avoided for 24 hours following an amniocentesis.

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Nurse’s Role in CVS

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