Dr. Madhavi Karki

CHORIONIC VILLUS SAMPLING

AMNIOCENTESIS

TIME 10-12 WEEKS 15-20 WEEKS

RESULT By direct preparation-24 hours, Culture – 10 days – 3weeks

Culture 3-4 weeks

Termination of Pregnancy

1st Trimester - safe 2nd Trimester- risky

Fetal loss 0.7% 0.5%

Accuracy Upto 97.5% may need amniocentesis for confirmation

Highly accurate (99.6%)

Maternal effects

Very little More traumatic psychologically and physically

PROCEDURE RELATED PREGNANCY LOSS RATE IS 1-2%

A normal, healthy fetal heart rate should possess average or moderate variability.

Decreasing variability is an indicator of possible stress.

• Accelerations: The fetal heart rate will normally remain steady or accelerate during uterine contractions. Look at the fetal heart rate and what is happening with contractions.

· An early deceleration begins at or after the onset of a contraction and returns

to the baseline rate by the time the contraction has finished and produces a mirror

image of the contraction. · Early decelerations are not a sign of fetal problems.

Late Decelerations: Late decelerations are transitory decreases in heart rate caused by uteroplacental insufficiency, a compromised blood flow to the baby that does not deliver the amount of oxygen needed to withstand the stress of labor.

The late deceleration begins after the onset of the peak or middle of the contraction and ends after the contraction. · A late deceleration begins during or after a contraction and has not recovered by the time that the contraction has ended. A late deceleration indicates decreased blood flow during uterine contraction. Note: Persistent late decelerations are ominous

Variable Decelerations: Variable decelerations are transitory decreases in fetal heart rate caused by umbilical cord compression.

A variable deceleration is unrelated to contractions. They mean umbilical cord compression. · They may appear V-shaped or U-shapedIf the baseline fetal heart rate remains stable and the variability remains good, variable decelerations are not associated with poor fetal outcome.·They indicate possible compromise if they become prolonged or are persistent.