What is villous puncture? Who needs villous puncture?

What is villous puncture? Who needs villous puncture?

What is villous puncture? Who needs villous puncture? Chorionic puncture is a kind of prenatal examination, which is helpful to know whether the fetus has chromosomal abnormalities. I sorted out what is villous puncture and who needs villous puncture, hoping to help everyone.

What is villous puncture? Who needs villous puncture? 1 villus puncture is a method that can confirm whether the fetal chromosome is abnormal in the shortest time. Generally, expectant mothers who need to be implemented arrange to have an examination at 1 1- 14 weeks of pregnancy. After the position of fetus and placenta was determined by B-ultrasound, chorion was scraped from cervix, abdominal wall and vaginal wall for analysis and detection. Although chorionic puncture can find fetal malformation about 1 month earlier than amniotic fluid examination, it is more likely to cause fetal damage than amniotic fluid examination because it is carried out in the first trimester.

The purpose of villous puncture

function

Chorionic puncture can be used for the diagnosis of prenatal diseases. The principle is to analyze the fetal chromosome and judge the fetal condition according to the results, such as whether there is Down syndrome or not, whether there are other genetic diseases, etc. The accuracy of chorionic puncture is high, reaching 99%, and it is widely used for expectant mothers who often have or give birth to deformed children. At the same time, because the villus puncture time is earlier, deformed children and sick children can be found as soon as possible, and abortion surgery can be done in time to reduce the harm to the mother.

purpose

1. Chromosome analysis: divided into direct method and culture method.

2. Gene analysis: It can diagnose single-gene genetic diseases, such as marine anemia.

3. Biochemical analysis: it can be divided into direct method and culture method, and the presence or absence of metabolic diseases can be judged by amniotic fluid analysis.

Which pregnant women need villous puncture?

Usually, if the mother's serum is found to be at greater risk, the doctor will recommend villous puncture to further determine whether the fetus's chromosome is abnormal. However, if all the indicators of pregnant women are normal, then there is no need to do this test. The following are pregnant women who need villous puncture:

1. Pregnant women who have given birth to children with genetic diseases. If the expectant mother has given birth to a child with genetic disease, then there is a certain chance that the fetus will have genetic disease because of the second pregnancy. Therefore, after the second pregnancy, doctors generally advise pregnant women to do chorionic tissue biopsy in the first trimester in order to find problems in time.

2. One spouse is the carrier of chromosome abnormality or abnormal balance.

3. Determine the sex of the fetus. It is necessary for carriers of sex-linked genetic diseases to know the sex of the fetus in the second trimester.

4. Have had children with neural tube defects or high alpha-fetoprotein values. The serum alpha-fetoprotein of pregnant women who have given birth to babies with neural tube abnormalities or themselves is significantly higher than that of normal pregnant women.

5. Older pregnant women. Pregnant women over 35 years old are worried about fetal development.

6. Screening high-risk pregnant women with Down syndrome.

7, thalassemia carriers. Both husband and wife are pregnant women with thalassemia of the same type.

8. Ultrasound showed abnormal fetal structure.

9. Family hereditary diseases. If there are suspected genetic diseases in the family, such as phenylketonuria, hemophilia, etc.

Villus puncture examination

1, transvaginal sampling method

Pregnant women need to lie flat with their legs bent and rely on their feet or knees to support their bodies; Under the direction of ultrasound, the doctor uses a thin and long puncture needle to pass through the place where the pregnant woman's vagina and cervix have villi, and uses a clean needle to extract a proper amount of villi, and then sends it to the examination. The extracted tissues need to be cultured first. If pregnant women have cervical lesions and reproductive tract infections, such as genital herpes, chronic cervicitis, gonorrhea, etc. Vaginal sampling method is not suitable.

2. Abdominal sampling method

If the placenta is close to the uterine forearm, it can also be punctured from the abdomen. Before this method is implemented, it is necessary to anesthetize the abdomen. The function of choriocentesis is very similar to that of amniocentesis, but because there are the same cells between villi and fetus, it is not necessary to make a judgment through this step of culture. In addition, this method is necessary for the diagnosis of some diseases, such as type A (α) marine anemia, because chorion contains a large number of cells, and enough DNA can be obtained to detect more abnormal phenomena.

Is villous puncture risky?

There is the possibility of abortion by villous puncture. Although there are great differences on its safety in the medical field, it does have the following risks:

1, the impact on pregnant women. A few pregnant women will have some abnormal situations after villous puncture, such as vaginal bleeding, amniotic fluid flowing out of the body surface, continuous uterine contraction and so on.

2, the probability of miscarriage is high. Randomly comparing the probability of abortion caused by choriocentesis and amniocentesis, it can be concluded that choriocentesis is more likely. However, related comparative studies have found that amniocentesis is more likely to have a miscarriage, so it is still inconclusive.

3. Fetal limbs are damaged. Compared with other puncture methods, chorionic puncture is more likely to damage fetal limbs, but in the case of undiagnosed diagnosis, amniotic sac puncture is needed for further judgment.

What is villous puncture? Who needs a villous puncture? 2. Precautions before villous puncture.

1, which is risky.

Many people are worried about the safety of villus puncture, because it needs to insert the puncture needle into the uterus and take a small amount of villus for testing. From the point of view of clinical medicine, villous puncture does have certain risks. Choriocentesis may lead to vaginal bleeding, amniotic fluid overflow or persistent uterine contraction, which will happen in about 2% pregnant women. According to the randomized controlled study of abortion rate after chorionic puncture and amniocentesis in the second trimester, it is found that the former is slightly higher, about 3%. However, other randomized controlled experiments have shown that the abortion rate after celiac chorionic puncture and amniocentesis in the second trimester is similar, which is 6.3% and 7% respectively.

In addition to the possibility of abortion, villous puncture may also cause fetal malformation. There was a news report that a pregnant woman in Anshan city became a victim of villous puncture. When she was four and a half months pregnant, she found that the fetus in her abdomen was abnormal in development, and her left arm, left calf and left foot were completely undeveloped. After consultation in the color ultrasound room and prenatal diagnosis center of the hospital, the conclusion is that fetal abnormality is caused by external factors, and the only reason is "villous puncture" at about 0/0 weeks of pregnancy.

However, judging from the overall situation of the whole country, the villus puncture technology is now very skilled, and the probability of abortion, water breakthrough and infection is also very low. After weighing its importance, expectant mothers who need this test don't have to worry too much.

2. Choose a regular big hospital.

Doing villous puncture examination is different from general routine examination, which has certain risks and requires high skills of doctors and hospital equipment. The expectant mother who needs this examination must go to a regular big hospital under the guidance of an experienced doctor.

3, do not need an empty stomach

The villous puncture test is different from the blood test, and an empty stomach test is not needed. In addition, if the examiner has symptoms such as a slight cold, it will not affect the exam. Some pregnant women with placenta previa can also do it.

Matters needing attention after villous puncture

1. Please don't leave in a hurry after the operation. Please rest for about 30 minutes, and then leave the hospital if you feel unwell.

2. It is normal that there may be some pain in the skin at the puncture site after operation. However, abdominal pain, increased or decreased fetal movement, vaginal bleeding or running water occurred after operation. Please inform us in time and we will arrange further examination or treatment.

3. If the above situation occurs after returning to China, and you live in other places or far away from our hospital, please bring your surgical records to the local hospital in time.

4. Rest for two weeks after operation, which is not suitable for strenuous exercise and manual labor. After 2-3 weeks, please go back to our hospital or local hospital to check the B-ultrasound, so as to understand the intrauterine situation of the fetus.

5, pregnant mothers should have a good rest after doing villous puncture, pay attention to a light diet, supplement nutrition, and be careful not to be tired.

In addition to the above precautions, it is suggested that expectant mothers should be psychologically prepared before the villous puncture examination, face the possible results of the examination, and take rational measures if the fetus is abnormal, so as not to cause more harm.