Exam (elaborations) MATERNAL A 327

1. Review all medications from list given during week 1—Clinical Simulation 2. Chorionic villus sampling (CVS) a. What is it? i. Chorionic villi—microscopic projections from outer membrane that develop and burrow into endometrial tissue as placenta forms; they’re fetal tissues and reflect chromosomal, metabolic, and genetic makeup of the fetus ii. Aseptic technique used iii. Transcervical aspiration—mom in lithotomy position; insert flexible catheter through cervix; guided using ultrasound; aspirate sample of chorionic villi through catheter into syringe filled with culture medium iv. Transabdominal—mom is supine; doc inserts needle through abdominal wall and myometrium until tip gets to placenta; take sample of villi for analysis b. Why is it used? i. Diagnose fetal chromosomal, metabolic, or DNA abnormalities ii. Cannot detect open body wall defects (ex: spina bifida—requires amniotic fluid sample) c. When is it done? i. 10-12 weeks’ gestation d. What are the advantages/disadvantages? i. Advantages—get results earlier in gestation than amniocentesis; if results are abnormal, woman may choose abortion and earlier abortion can be less physically/emotionally traumatic than late abortion ii. Disadvantages/Risks—small risk for limb reduction defects; must remove mom’s cells from sample before testing; same risk of losing pregnancy as amniocentesis; fetal loss chances increased if more than 2 attempts are done of there is bleeding the week before the procedure e. How long does it take for the results to be available? i. Preliminary results in 2-3 hours ii. Incubate cells for 2-4 days then analysis again within 7 days f. Outline the care after the procedure is complete. i. After CVS, fetal heart activity is documented ii. Maternal VS assessed and woman is allowed to void .......................................CONTINUED...................................