Most gynecologists do a biopsy when there is a suspicion of the presence of various oncological diseases among women.
What is a biopsy?
Typically, women undergo a cervical biopsy. In the process of its implementation, the tissue of a part of the uterus is directly taken for its analysis. Most doctors say that a cervical biopsy is performed only for women who have already given birth, and expectant mothers and those women who are just planning a pregnancy should refuse to undergo such a procedure.
Biopsy during pregnancy: features
As soon as the expectant mother registers with the gynecologist at the antenatal clinic, she should go through a list of tests from the very beginning, among which there may be a biopsy procedure. The doctor can prescribe such a procedure if any pathological processes in the uterus. However, even for the purpose of investigating the detection of erosion (dysplasia) of the cervix, the procedure during pregnancy is highly undesirable. There is a completely logical and simple explanation for this - its implementation involves stretching the cervix with a small wound, when tissue is taken for analysis. Such actions can cause contraction in the uterus and provoke the fetus
Sometimes doctors explain the need by the fact that the situation is quite serious: the detection of cancer cells in a pregnant woman, when the pregnancy is interrupted to save the mother's life. However, at the same time, the chance of gestation and birth is quite serious. healthy baby, after which the woman can start treatment and agree to a biopsy.
In early pregnancy, the biopsy does not threaten the health of the pregnant woman and her baby. If the doctor continues to insist on conducting a study during the second half of pregnancy, it is not worth the time and turn to another specialist, since this situation requires additional information.
From the very beginning, you should not go for a biopsy, since you can limit yourself to the necessary tests and smears, consult with different specialists, the danger and risks of such an analysis during pregnancy. It should be noted that most women can get rid of cervical erosion after the birth of a baby and this is quite successful. Health to you and your children!
Everyone wants to have healthy children. Of course, not everything is in the hands of a person, but, nevertheless, it is currently possible before the birth of a child, for enough early dates, with a guarantee of almost 100% to find out whether the child has chromosomal abnormalities, in other words, whether he has a normal karyotype.
Karyotyp- a set of features (number, size, shape, etc.) of a complete set of chromosomes, inherent in the cells of a given biological species.
Normal human karyotypes - 46, XY (male) and 46, XX (female). In cases where a child has chromosomal abnormalities, his karyotype will be different.
So, the most famous chromosomal anomalies - Down syndrome (three 21 chromosomes) corresponds to the karyotype 47, XY, 21+ or 47, XX, 21+, Edwards syndrome (three 18 chromosomes) corresponds to the karyotype 47, XY, 18+ or 47, XX, 18+, etc.
The severity of the consequences for the child's health with different anomalies is also different - there are both severe anomalies that simply lead to an arbitrary termination of pregnancy in the early stages, and relatively "mild" and "viable" - for example, Down's syndrome.
It is worth noting that chromosomal diseases do not depend in any way on the lifestyle of the parents - these are mutations that arise spontaneously and predict them no way(with the exception of a very small percentage (3-5%) of chromosomal abnormalities, which are inherited and usually known in the family).
That's why, healthy image life and the absence of relatives with chromosomal diseases, for example, in no way does not guarantee the absence of an anomaly in the unborn child in this particular family.
There are several methods to find out in advance, during pregnancy, if the baby has a chromosome problem. For the reasons described below, I chose for myself exactly chorionic biopsy. main reason- 99% guarantee of the accuracy of the result.
Chorionic villus sampling- obtaining a tissue sample of the chorion (future placenta) in order to identify chromosomal diseases and the carriage of chromosomal abnormalities. Chorionic tissue, in general, has the same genetic structure as the fetus, therefore it is suitable for genetic diagnosis.
Chorionic tissue is obtained by puncture of the uterus through the anterior abdominal wall with a catheter.
Why then chorionic biopsy, if it is so accurate, is it not prescribed to all pregnant women in a row? Because it invasive method(material sampling is required) and he has a certain percentage of complications - the likelihood of termination of pregnancy: before 2% .
In Russia, pregnant women in mandatory only prenatal screening is carried out, it consists of an ultrasound scan and a blood test for hormones: hCG and PAPP-A. Neither the ultrasound results nor hormones provide a basis for the diagnosis of chromosomal abnormalities in a child. They only show risk, that is, the likelihood of these violations.
But in practice, there can be an ideal ultrasound scan and an ideal blood test - and a sick child is born. And, on the contrary, according to ultrasound and blood, everything is bad - and the child has a normal karyotype. The frequency of errors and discrepancies is so high that I would put classical prenatal screening on a par with fortune telling and weather prediction.
But, since one of the traits of a Russian person is the hope of chance, multiplied by terrible tales about a mandatory miscarriage after a puncture of the abdomen and the stories of girlfriends who have already given birth to healthy children that: "Are you dangerous, don't even think about a puncture, you see, everything is fine with me (Masha, Dasha, Glasha) "- all this only leads to the fact that women are afraid of invasive diagnostics like fire and write rejections all over the place, even after getting bad results prenatal screening.
In the first pregnancy, I did not do invasive diagnostics - I was young and stupid. I was lucky - everything is normal with the child's chromosomes (by the way, the blood screening was bad and I refused to have the geneticist punctured). However, having delved into a childish theme, looking at deeply sick children, at a familiar 21-year-old girl who gave birth to a son with Down syndrome with good screening, and having matured, I came to my second pregnancy with a firm idea of what I would do chorionic biopsy in any case. Of course, you cannot protect a child from everything, but, nevertheless, it is possible to completely exclude a breakdown in his chromosomes. And this is within my power.
It is worth noting here that the reaction to my desire to voluntarily do chorionic biopsy, or, learning about this after the procedure of various doctors, ranging from a gynecologist and ending with a geneticist and ultrasound specialists, was absolutely identical. At first surprised face, then I was asked "Voluntarily ??" this procedure absolutely without any indication, at will. And here the doctors can be understood - they do not have rose-colored glasses, they have seen and heard a lot, alas.
But, closer to the procedure itself chorionic biopsy... After visiting a geneticist, I received a list of tests that need to be passed:
In terms of preparation: two days before the puncture, insert papaverine at night. On the advice of a gynecologist, I inserted it within three days after the procedure. Obstetric term I had 13 weeks on the day of the procedure ( chorionic biopsy do up to 14 weeks).
On the appointed day, I came to the clinic in the morning, took myself a ward for the day. This is important - after the puncture, you need to lie down, everything should be in a very calm, snail-like mode.
After signing the papers, I went up to the office. Actually, the procedure itself is done by two doctors: an ultrasound specialist and a functional diagnostics doctor who takes the material. Undressing from the waist down, I lay down on the table. The ultrasound specialist found the child with a sensor, together with the second doctor, they determined the place where the needle should be inserted. After that, I was given an anesthetic injection in my stomach (it didn’t hurt, but I didn’t understand the effect from it either).
After waiting for the time for the injection to act, the child was again found with an ultrasound sensor, and the second doctor began to insert the needle into the lower abdomen and draw material into the syringe. Everything is under continuous ultrasound control. It lasted 15-20 seconds, and it hurt, more painful than a regular injection, but nevertheless it ended quickly enough. After that, the ultrasound sensor again followed the child's heartbeat, sealed his stomach with a plaster and sent him to rest in the ward.
The belly sipped, as with menstruation, released somewhere in half an hour. I put in papaverine. Exactly an hour later, I went to the control ultrasound, which showed that everything was in order with the child, and went back to the ward to lie down until the evening. After sleeping off, taking off the plaster, in the evening I went home. There was a small trace left, as from an injection, healed quickly.
Then, of course, there was a week of waiting for the results and, finally, a call from the geneticist: you have a healthy boy. You can breathe out.
So, the reasons why I decided to do chorionic biopsy:
- Held genetic analysis the fetus itself (chorion - the future placenta), and not hormones in the mother's blood. This is similar to the fact that a person who has already been born takes an analysis for his karyotype. Reliability 99%.
- Invasive methods are our last resort. If the ultrasound and prenatal screening data are very bad, before termination of pregnancy, an invasive diagnosis is made first to confirm it.
- There is an analogue chorionic biopsy- non-invasive test, where the child's DNA is taken from the mother's blood. But, in the case bad result, you will not be terminated, but will be offered, again, invasive diagnostics for confirmation. In addition, the cost of a non-invasive test is still very high (in our city from 40,000), but the guarantee is still less than that of chorionic biopsy.
- As for the risk of spontaneous abortion after biopsy is 2%. Here, my personal opinion is this: if after chorionic biopsy there was a miscarriage - this is a matter of the viability of the fetus. Most likely, the interruption would have happened anyway.
UPDATE. I had no complications after the chorionic villus biopsy. At the age of 38 + 5 she gave birth to a healthy boy weighing almost 4 kg (planned CS).
● ● ● ● ● ● ● ● Sincerely, Lisiya ● ● ● ● ● ● ● ●
P.S. My reviews on pregnancy and conception:
- Ovulation Test Showing In 4 Days - Clearblue ADVANCED DIGITAL Ovulation Test
- Innate Response Formulas All Natural Vitamins Baby & Me Trimester I & II for Planning and Pregnant Women
Analyzes and studies accompany each future mother... Since registration, she has to take hundreds of different tests so that doctors can track her health and baby's development.
In addition to standard examinations, doctors may insist on new and unfamiliar procedures. If the doctor suspects something is wrong, or wants to be sure of harmonious development baby, he can direct you to additional analyzes... One of them - fetal biopsy during pregnancy.
Chorionic villus sampling ( BVH) - a method for determining chromosomal abnormalities in a baby. Through this study, discover possible pathologies it is possible long before childbirth. A biopsy can almost accurately tell if the baby has developmental abnormalities, for example, Down syndrome.
However, like everyone deep research, BVH has its pros and cons. The procedure itself takes place in the supine position. Constant ultrasound control of the fetus is carried out, due to which it is established exact date pregnancy and the place of localization of the placenta.
- Transcervical CVH... It is carried out for a period of 11-13 weeks. The doctor reaches the placenta through a catheter inserted through the cervix;
- Transabdominal CVH... This method allows examinations to be carried out at a later date (after the 11th week). The study passes through the abdominal wall. The puncture site is numbed and a biopsy needle is inserted.
Both studies are carried out under constant ultrasound control. After removing the microvilli, which resemble small flagella, the doctor sends the material for analysis. The cells selected by a biopsy contain all the necessary information about the chromosome set of your baby, which will allow identify developmental abnormalities.
The biopsy is done quickly enough. Women experience discomfort similar to a vaginal smear. Some people begin to feel throbbing pains, but they are fleeting. After the second biopsy method, pregnant women feel pain in the lower abdomen, at the puncture site.
After the procedure, the woman may feel tired. It is advisable to immediately rest after the biopsy, since painful manifestations in the abdomen are possible on the first day. Sometimes there is a slight uterine bleeding... These are the usual side effects procedures, however, you still need to tell your doctor about them. If a temperature appears, cramping pains and chills are felt, you should immediately contact an ambulance.
The main advantage of a biopsy is that it performed early in pregnancy... If abnormalities are found in the unborn baby, the woman is offered to spend additional research on deviations in the development of crumbs. At this time, the pregnant woman must decide whether she wants to keep the pregnancy.
A biopsy is a mandatory procedure for women giving birth after 35, as well as for those who have had hereditary abnormalities in the family.
Pregnancy is a happy, but at the same time, very anxious time. Prudent women during the period of bearing a child are registered with antenatal clinic and pass everything on time required analyzes... For flow healthy pregnancy it is extremely important to cooperate with a doctor who supervises a woman during this important period of her life.
Biopsy during pregnancy - method prenatal diagnosis condition of the fetus in the womb. There are 4 types of such prenatal examination:
- chorionic villus sampling (future placenta);
- placentocentesis;
- amniocentesis;
- cordocentesis.
These procedures are complex and have a certain risk, so they are not prescribed simply out of the curiosity of the parents or at the whim of the doctor. Before agreeing to such a diagnosis, a pregnant woman should weigh all the pros and cons.
Chorionic villus sampling
Chorion is the outer fetal membrane of the embryo. Chorionic biopsy (CVC) is a study of the cells of the outer fetal membrane containing the same hereditary material (karyotype) as the developing fetus. Analysis of the karyotype makes it possible to identify severe pathologies of the development of the embryo in the 1st trimester, when others medical procedures, associated with penetration through the natural external barriers of the body, are categorically contraindicated.
BVH is performed at 8-12 weeks of pregnancy. Later, it is not recommended to do such a procedure, since at 13 weeks the placenta develops from the chorion. But before 11 weeks, there is a risk of impaired development of the child's limbs.
This diagnosis is carried out in such cases:
- If a woman becomes pregnant over the age of 35. In "old-born", the likelihood of developing fetal pathologies increases.
- One of the parents has genetic abnormalities (malformations, hereditary diseases, chromosomal rearrangements).
- The child was conceived as a result of incest (parents are siblings).
- In the history of the disease, primary infertility was noted, miscarriages occurred, previous children were born dead or with genetic disorders.
- In the early stages of pregnancy, a woman took embryotoxic drugs, took x-rays, or inhaled toxic vaporous substances.
Chorionic biopsy can detect Down syndrome, trisomy 18 chromosome, the presence of an additional 13 chromosome in the cells and other diseases at the genetic level in the fetus, as well as determine gender and establish paternity.
Fence of material for similar diagnostic research contraindicated in such cases:
- the existing threat of miscarriage;
- the pregnant woman has inflammatory diseases on skin abdomen, vagina, or cervix;
- the woman is a carrier of HIV infection.
BVH is not devoid of risks and consequences. The main ones are:
- In 1-2% of cases, after the manipulation, a miscarriage occurs.
- In 0.1-0.5% of cases, intrauterine infection occurs.
- Peels off fetal egg against the background of the formation of retrochorial hematoma.
Doctors do not insist on a chorionic biopsy and future parents always have a choice.
Placentocentesis
This procedure involves obtaining placenta cells to study their chromosomal and genetic structure. It is finally formed by the 16th week of pregnancy, so it is advisable to conduct a biopsy in the 2nd trimester. This study has no fundamental differences from CVH, since the placenta is formed from the chorion.
The main advantage of placentocentesis is quick receipt result in case of suspected hereditary pathology within 2 - 4 days.
Before a cytogenetic study can be carried out, fetal cells are planted on nutrient media to increase their number.
Amniocentesis
This prenatal diagnosis is a study of the biologically active fluid inside the membranes during pregnancy and fetal cells, which are exfoliated skin epithelium.
Amniocentesis is performed no earlier than 16 and no later than 24 weeks of pregnancy. During this period, the risk of miscarriage is reduced, and besides, this diagnostic method is more informative than CVS or placentocentesis.
This study allows you to detect hereditary diseases caused by changes in the number or structure of chromosomes in the fetus. In addition, by the type and composition of the amniotic fluid, it is possible to assess the degree of maturity of the fetal lungs, to identify oxygen starvation or to determine the severity of the humoral immune response of the Rh-negative mother to the erythrocyte antigens of the Rh-positive fetus.
After amniotic fluid is received, it is delivered to the laboratory and fetal cells are isolated from it. The results of the analysis will have to wait from 14 days to 1.5 months. Cytogenetic analysis of waters normally shows the content of 23 pairs of normal, without structural abnormalities of chromosomes.
Cordocentesis
This diagnostic method is a puncture of the umbilical cord of the fetus for the purpose of taking blood or administering drugs. Although it is possible to carry out such a procedure after the 18th week of pregnancy, the optimal period is 22-25 weeks. Advantage this method- the risk of miscarriages is minimized, but at the same time, a high percentage of information content remains in relation to the detection of gene and chromosomal diseases.
A pregnant woman may have many questions related to the recommended diagnostic measures, and the doctor is obliged to answer them in detail.
Cervical biopsy
Cervical biopsies are usually not performed in pregnant women. Carrying a baby is not the right time for such a procedure, because during it you need to stretch the cervix and "wound it" (take its tissues for analysis), the answer to which may be contraction of the uterus and provoking a miscarriage.
And yet, in some cases, doctors may insist on an endometrial biopsy, since if the study reveals cancer cells, you may have to terminate the pregnancy in order to save the woman's life. However, there is also a very high probability the fact that in such a state a woman will be able to wait for childbirth and only then agree to a biopsy and start treatment.
If there is no other choice and the pregnant woman is nevertheless prescribed a biopsy, then they resort to the pipel method. In the process of such a procedure, there is no need to use pain relievers, expand the neck or cause discomfort in any other way. For tissue sampling, a tube of 3 mm in total diameter is used, inside which there is a small piston. It delicately enters the uterus and separates with a piston the right amount fabrics or liquids.
Still, you shouldn't take such a risk right away. First, you should pass all the necessary tests and smears, consult with several specialists, because a biopsy while carrying a child is quite risky and dangerous.
Breast biopsy
Breast cancer on this moment continues to lead against the background of other cancers in women of reproductive age. Often, this pathology is found in pregnant women or in those who have recently given birth. Diagnose cancer on early stage in this category of patients it is problematic due to physiological changes in the tissue of the mammary glands in such a special period for the female body.
In normal cases, puncture and biopsy provide the most reliable results... However, pregnant women often have false positive cytological responses. The most reliable in this case will be the study of the material obtained by trephine biopsy or by excision of a small piece of tumor tissue.
A biopsy during pregnancy may be done to examine the fetus or to identify serious pathologies from a woman. These procedures are associated with a certain risk to the health and life of both a woman and a pregnant child, therefore, they require the collective participation of doctors of various profiles. But these experts can only recommend certain diagnostic methods, and the decision is made by the future parents.
Diagnostic testing that detects chromosomal abnormalities and other hereditary diseases of the fetus is called chorionic biopsy. Testing is recommended by a family doctor if paternal or maternal line potentially dangerous diseases are traced.
Diagnosis is carried out in the early stages of pregnancy by the method of invasive examination of the tissues of the future placenta. The purpose of testing is to identify chromosomal abnormalities or monogenic hereditary diseases - hemophilia, cystic fibrosis, hereditary pancreatitis, Marfan's syndrome, achondroplasia, congenital cataracts, mental retardation, Down's syndrome and many other inherited diseases.
Chorionic biopsy is an invasive method of prenatal diagnosis with invasion of the uterine cavity and sampling biological material- chorionic villi. The essence of the study is to obtain a small piece of tissue from the future placenta. Tissue cells are unique in that they contain the same chromosomes as an infant developing in the womb.
The identity of the cells of the placenta and the fetus that begins its development makes it possible to determine already in the early stages of pregnancy whether the child will be burdened with hereditary diseases at birth or not.
Did you know? Chorion biopsy allows you to carry out chromosomal analysis of cells developing inside the baby's womb, without affecting the fetus itself.
Who is the procedure indicated for?
- Women who become pregnant at the age of 35 (and older);
- The results of the first screening test indicate the risk of having a baby with Down syndrome;
- In the case of early determination of the sex of the child, since hereditary hemophilia or Duchenne dystrophy was observed along the paternity line;
- When on the line of relatives there is already the fact of the birth of a child with Down syndrome or other hereditary diseases associated with an abnormal set of chromosomes, as well as a genetic disorder;
- Identifying development congenital malformation in a developing fetus with ultrasound.
Unfortunately, the method of diagnostic testing is not carried out in every clinical laboratory. In addition, a chorionic biopsy is a rather expensive pleasure, and not everyone family budget it will "pull". The presence of medical insurance provides coverage of part of the costs for women over 35 years old, well, and the rest of potential patients are forced to look for alternative methods research.
How and for how long is the chorionic biopsy performed?
The optimal timing for testing for defective chromosomes is considered to be the period from the 9th to the 12th week of pregnancy, inclusive. The procedure is carried out under the control of equipment ultrasound examination... The selected biomaterial is processed and examined for two or three, extremely rarely - seven days.
A tiny piece of tissue is taken from the point of attachment of the chorion to the uterine wall. A few cells are enough to conduct a full study of the biomaterial.
The material is taken in one of two existing methods conducting research diagnostics.
- Transcervical method(transcervical modum) consists in introducing a thin catheter through the cervix and bringing it to the placenta protrusion. Control over the process of sampling biomaterial is carried out using ultrasound. The chorionic villi are gently removed by a catheter, after which the catheter is removed from the body. This method of taking a chorionic biopsy is considered the most common.
- Transabdominal method(transabdominal modum) examination consists in taking a puncture. Under local anesthesia, the abdomen and uterine wall are punctured with a thin long needle, which, under ultrasound control, is brought to the placenta and the chorionic villi are taken. After manipulation, the needle is removed.
The first method allows you to take material in larger volume, and the analysis result is prepared faster than with the second method.
What Chorionic Biopsy Results Show
Receipt negative result testing suggests that at the genetic or chromosomal level abnormal development the fetus is not observed. But the birth is not guaranteed completely healthy child, as well as the possibility of further occurrence of certain problems related to his health.
Upon confirmation of a serious pathological disease ( positive result testing), there is a short period of time for which it is necessary to take the most important decision- leave or terminate the pregnancy.
- Medical abortion (artificial interruption pregnancy) can only be carried out during the first trimester. If a woman decides to inform and give birth to a child, it is necessary to inform relatives about the predicted deviation in the baby's health.
- If the child has a congenital defect will require immediate surgical intervention immediately after his birth, it is necessary that the birth takes place in a specialized specialized clinic, where the child will be provided with appropriate assistance.
- It is also necessary to immediately decide - childbirth will be carried out naturally, or you will need to have a cesarean section.
Important! No research guarantees 100% reliability of testing.
A number of cases have been recorded when, with a positive result of fetal pathology, a woman was completely relieved of the burden. healthy child... True, there were also mistakes of the opposite plan, but, according to medical statistics, there were much fewer of them. Chorionbiopsy accuracy rates are approaching 99%.
Risks and consequences
Judging by the assessments of women who underwent diagnosis through taking a chorionic biopsy, and as noted by their reviews, this procedure is painless, but it can cause some discomfort. Especially in the area of the puncture during the transabdominal testing method.
Invasive examination of chorionic villi is penetration into the uterus with developing fetus... Therefore, there are certain risks associated with taking a biomaterial with any testing method:
- The risk of intrauterine infection increases;
- There is a short leakage of amniotic fluid;
- There is a cramping, but quickly ending pain in the lower abdomen;
- It is extremely rare - violation of the integrity of the fetal bladder.
Did you know? Spontaneous termination of pregnancy after a chorionic villus sampling is extremely rare, and occurs in one in 440 women, which is 0.4% of the number of those who have passed the examination.
In what cases the examination is not carried out
- With the threat of miscarriage.
- The uterus is in a state of hypertonicity
- Chronic diseases are aggravated.
- When bloody discharge from the cervix.
- Diagnosed uterine myoma.
- The presence of adhesions is noted in the small pelvis.
- Lack of access to chorionic villi.
- When a woman is pregnant with twins.
- When the uterus is bent.
Video
From the informational video offered for viewing, you will learn a lot of new and useful information about diagnostics by testing and taking samples for a chorionic villus biopsy. Talking about chromosomal pathology the fetus, destroying all fears of the procedure, is carried out by an obstetrician-gynecologist, a doctor the highest category Gulnor Myrzabekova.
Actual information
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If you had a chorionic villus sampling, please share your impressions. What did you feel at the time of the diagnosis, and how long it took. Were there any difficulties in the period after the tests, and how you dealt with them. Looking forward to your answers. All comments, reviews and Additional information can be left on this page under the article. Take part in the discussions, and together we will make our site the most informative.