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While recognizing the aforementioned risks, the American College of Obstetricians and Gynecologists recommend that prenatal screening, or diagnostic testing for aneuploidy via procedures like amniocentesis or chorionic villus sampling, be discussed with and offered to all patients regardless of maternal age or risk profile. [5]
To reduce the risk of intraamniotic infection, antibiotics are supplied through the intravenous access about 30–60 minutes before the procedure. If movement of the fetus is a risk to the success of the procedure, the fetus may be paralyzed using a fetal paralytic drug. [10] This image shows anterior blood sampling from the umbilical cord.
The demand for cordocentesis tests is diminishing because it has been replaced with CVS and Amniocentesis, which carry less risk. The procedure is typically done via needle into the mother's abdomen, in combination with ultrasound for guidance, to obtain a blood sample from the umbilical cord of the fetus. [18]
Noninvasive prenatal testing (NIPT) is a method used to determine the risk for the fetus being born with certain chromosomal abnormalities, such as trisomy 21, trisomy 18 and trisomy 13. [ 1 ] [ 2 ] [ 3 ] This testing analyzes small DNA fragments that circulate in the blood of a pregnant woman. [ 4 ]
Chorionic villus sampling is a prenatal procedure which involves a placental biopsy. Most commonly when CPM is found it represents a trisomic cell line in the placenta and a normal diploid chromosome complement in the baby. [2] However, the fetus is involved in about 10% of cases. [3]
The risk of miscarriage in CVS is estimated to be potentially as high as 1–2%. However some recent research has suggested that only a very small number of miscarriages that occur after CVS are a direct result of the procedure. [6] Apart from a risk of miscarriage, there is a risk of infection and amniotic fluid leakage.
Amniotic fluid is removed from the mother by an amniocentesis procedure, where a long needle is inserted through the abdomen into the amniotic sac, using ultrasound guidance such that the fetus is not harmed. Amniocentesis is a low risk procedure, with risk of pregnancy loss between 1 in 1,500 – 1 in 700 procedures.
Fetoscopy is an endoscopic procedure during pregnancy to allow surgical access to the fetus, the amniotic cavity, the umbilical cord, and the fetal side of the placenta.A small (3–4 mm) incision is made in the abdomen, and an endoscope is inserted through the abdominal wall and uterus into the amniotic cavity.