Tissue sampling Chorionic Villus Sampling

Chorionic Villus sampling (CVS)


Villi are part of the development of placental structure. Chorionic biopsy means collection of a small sample of chorionic villi for the purpose of genetic testing during pregnancy.  CVS enables testing for some genetic disorders. 


There are several reasons why CVS is recommended:


When is CVS performed?

CVS is usually performed between 10 and 13 weeks of pregnancy.


How is CVS performed?

CVS includes taking small amount of tissue sample from the developing placenta which contains the same genes as the baby’s. First ultrasound scan is made to determine fetal and placental positions.
Then chorionic tissue is collected. There are two methods for accessing   chorionic villi: abdominal in case of anterior placenta, and transcervical through the vagina in case of posterior placental position. As the number of complications is higher in vaginal CVS, abdominal CVS are more frequent, that is abdominal procedures are preferred in an effort to avoid possible complications. In case of posterior placenta, the test is made at a later week by amniocentesis.
The tissue is collected by a thin needle through the abdomen skin and uterus wall from the placenta. The procedure is monitored by ultrasound for the needle to be inserted in the correct place. Placental tissue sucked through the needle is then sent for laboratory testing.


Deciding whether to have a CVS test

Deciding whether to have a CVS test during pregnancy may be difficult. It is important to know that you don’t have to go for a CVS test if you are not willing to. You should decide for the test only if you and your partner would like to get the information resulting from the test, not feeling it will be too risky to undergo the test.  

Discuss frankly with your doctor - who may help you with the best decision for you and your child - the following issues:


Is CVS painful?

You will be given a detailed instruction on the procedure. Most women describe the CVS test as not pleasant rather than painful, similar to menstrual discomfort, mentioning after the test they felt some pressure and slight pain in the area of the needle penetration. 


What to do after CVS?

The procedure takes about 15-20 minutes. Thereafter you will rest in the hospital for about an hour. For several days after the test you should limit your activities to light work, not lifting heavy objects and not doing any strenuous exercise.
Following CVS some women may experience light bleeding or cramping similar to menstrual cramps. If the bleeding is heavy, you must contact your doctor. Avoid an intercourse while bleeding.

What are the risks of CVS tests?

Following the CVS test, pregnancy continues normally, in 98 - 99 out of 100 cases (98-99%). According to available statistics, one or two women out of 100 may miscarry (1-2%). The reasons of miscarriage are not clear at present.


Is CVS reliable?

You may consult the particular genetic testing with your doctor, discussing its accuracy and reliability. Genetic tests differ, depending on the type of genetic or chromosome anomaly for which the test is made.
Exceptionally it may happen that the test was unsuccessful and has to be repeated.


Can all genetic diseases be detected by CVS?

The test typically presents information only of the disease for which it was performed. In exceptional cases the test may reveal the result related to another disease. Generally, however, this test does not find all genetic diseases.


How long do I have to wait for the CVS results?

The time for getting the results depends on the disease for which the test has been made. With some diseases three days will be enough, and with others 2-3 weeks may be necessary. If the results take longer than mentioned, it need not mean there are any unusual findings, but the cells may have taken longer to grow. 
If you take a CVS test because of a rare genetic disease, ask your physician how long you will have to wait for the results. As soon as the CVS results are available, your doctor may call you for a consultation, or you may be informed by phone. You should agree with your doctor in advance on the method of notifying you about the test results.


What happens if the test results show a fetal genetic disease?

If the results show a fetal genetic disease, your physician will discuss with you what it means, and how the fetus may be affected. Together he will guide you through all the options of treatment and care. You may also talk about what you wish to do, and about the possibility of termination of pregnancy. The doctor will help you decide on the best solution for you and for the fetus.

This is just the brief information you should get when deciding about CVS testing.

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