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View Full Version : if you lost a pregnancy did you have a CVS or Amnio?



AnnieW625
10-05-2009, 01:26 PM
with subsequent pregnancies?

I am outing myself I am 9 weeks pregnant (today), due 5-10-09. I feel really positive about this pregnancy (measuring at 8 wks, 2 dys, last Wednesday). We lost #2 to trisomy 18 last April at 24 weeks. Since prior pregnancy (DD) was healthy we were not given the option to see genetic counseling until my 17 u/s came back positive for some abnormalities and by the time I finally saw the perinatologist, and genetic counselor a month later (my prior OB who is no longer with the practice was a little care free and totally mishandled everything IMHO I should've gone to the GC immediately and the perinatologist a lot sooner too) and had the amnio a week later it was 24 weeks when we found out about the trisomy 18, and 26 weeks before the final D&E surgery. It was heartbreaking to say the least.

So what has everyone done? Genetic counseling called and I am on the fence about setting anything up with them because I have been so positive about this pregnancy (everything has been better, no excess fluid leakage, a lot more tired, no morning sickness (had zero with DD, and I know that indicates nothing, but I couldn't even keep simple calcium pills down with #2 for the entire pregnancy) and better measurements at first OB appt; (looking back #2 measured very small, even at 6 weeks when it was undetectable using the intra uterine u/s wand). We plan to tell everyone including our parents after my 13 week appt. at the end of this month, which also includes an u/s to measure for the nuchal fold to rule out/determine downs syndrome. IRL DH and I are the only ones who know, and as long as I can stay in my current work clothes no one at work will have to know either. DH is fine with me getting an amnio, but I really wonder if the CVS test done before 13 weeks might just ease my mind a bit.

mommylamb
10-05-2009, 01:30 PM
No BTDT, but just wanted to say CONGRATULATIONS!!

BabyMine
10-05-2009, 01:40 PM
Congratulation!!. I had the amnio done.

Laurel
10-05-2009, 01:43 PM
I'm so happy for you! Sending positive thoughts your way! No BTDT advice to share.

MoJo
10-05-2009, 01:45 PM
No BTDT but congrats, and so happy this time seems to be going so much better!

kdeunc
10-05-2009, 01:47 PM
Congratulations! I did have an amnio with DD which was after a loss but not because of the loss.

At the nuchal scan they usually can do bloodwork which gives you the odds for Down Syndrome and the other trisomy disorders. You may want to ask about that part of the test. I know that my results came back increased for Down Syndrome but way decreased for the other options and I was offered CVS then or Amnio a few weeks later. I chose amnio. Looking back I think I would really consider CVS after a questionable nuchal screen. It was a long 5 weeks before my amnio only to find out that everything was fine. Good luck!

citymama
10-05-2009, 01:53 PM
I am outing myself I am 9 weeks pregnant (today), due 5-10-09.

We are due the same date! I am 9 weeks today as well. Yay!

Has your OB set you up for a first trimester screening? That's a non-invasive first screen that will evaluate your risk and need for any more advanced screening. I would definitely do the first-trimester screening if I were you - I have my first midwives' appt. later today and am going to schedule my screening ASAP. It's simply a blood draw plus high-quality ultrasound. This may be what they will do at your 13 week appt, but I believe it should be done b/w week 10-12 to be accurate and effective.

pinkmomagain
10-05-2009, 01:54 PM
I've never suffered a loss, but chose to have a CVS done with dd3 due to my age at the time. I was very happy with the piece of mind it gave me.

pb&j
10-05-2009, 01:56 PM
No, because 1) my first pregnancy loss at 24 wks was not genetically linked - the baby's amnio was normal, but she had severe birth defects and 2) I did the 1st tri nuchal translucency screening and had great results. The 1st tri screening not only screens for Down Syndrome, but also for Trisomy 13 and 18. Make sure it's done by a specially trained/certified practitioner. Had I had abnormal results on the 1st tri screen, I would not have hesitated to have an amnio.

Congratulations, and best wishes for a healthy, uneventful pregnancy.

AnnieW625
10-05-2009, 01:58 PM
We are due the same date! I am 9 weeks today as well. Yay!

Has your OB set you up for a first trimester screening? That's a non-invasive first screen that will evaluate your risk and need for any more advanced screening. I would definitely do the first-trimester screening if I were you - I have my first midwives' appt. later today and am going to schedule my screening ASAP. It's simply a blood draw plus high-quality ultrasound. This may be what they will do at your 13 week appt, but I believe it should be done b/w week 10-12 to be accurate and effective.

That is what is being done at the next appt., which according to my date calendar at work is 12 wks and 3 dys so still in that 10 to 12 week range:) Kaiser is great about setting up the dates as far and advance as possible and I really appreciate that. This whole screening/nuchal scan u/s, and presuming blood work is new at my clinic (I was at a different Kaiser with DD and I don't recall having more blood work in between the initial and the AFP). With DD I had my AFP at the same time as my 17 week u/s. I am really happy they added it to the schedule. That's why we figured we'd just wait to tell parents and everyone else until then.

ETA: the u/s tech who is handling the 12 week u/s is specific to the OB department and is not one of the ones from the hospital where the 17 week u/s is done. :) I actually saw her with #2 after my initial orientation/appt. set up meeting (she just happened to be in the office and the RN said I could go over and see her) and she was the one who didn't detect the fetus at 6 weeks (which honestly should've been the first sign something was wrong with #2; slow growth is one of the major signs of tri-18).

arivecchi
10-05-2009, 02:07 PM
Yes, do the first trimester screening. Much more accurate than the quad test and not invasive.

saschalicks
10-05-2009, 02:08 PM
I never had a loss. However, w/my last pregnancy I was offered the Nucheal (sp?) test w/bloodwork and u/s at around the 10-12 week mark w/enough time to go for a CVS should anything show up. We opted to do the test although I had 2 healthy babies. I just wanted to be sure I took every test I could (I'm a cautious person what can I say). Everything came out great, but I thought for what the test did it was not very invasive. I got a good result and didn't go for the CVS. Had I gotten a bad result from that test I would've done the CVS over Amnio simply b/c at that point my patience and mind would have been shot.

GL w/everything and congratulations.

BTW, which Kaiser do you go to? I used to be Kaiser (but that was before children).

ETA: I'm sure you meant your EDD to be 5/10/10 right? ;)

egoldber
10-05-2009, 02:13 PM
I had 3 unexplained first trimester losses so I was not willing to do an amnio/CVS without a specific reason. But I was also 38 when I was pregnant with Amy. So I had the nuchal fold with ultrasound (that looks for the nasal bone) blood work combo at 12 weeks and my odds went from 1 in 400ish to 1 in 8000. I also had a Level 2 ultrasound with a high risk OB practice at 16 weeks to check for potential defects. All that taken together I was comfortable declining the amnio/CVS.

Now, in your case, having had a baby with Trisomy 18, I would at least see the genetic counselor (if you haven't already). I'm honestly not sure what I would do.

But congrats! :hug:

sste
10-05-2009, 02:22 PM
Annie, all of my pregnancy losses were so incredibly early that a less compulsive person would not even have realized they were a loss - - so my experience is not like yours.

I am seconding the rec to see a genetics counselor. They will likely advise from a medical standpoint the nucal/blood test and then a cvs/amnio only if the screen indicates an elevated risk. If you get to that point and have to choose get the cvs - - with a highly experienced practitioner the risk is barely elevated from an amnio and the cvs is MUCH better in my opinion for the mom's mental health and for reducing the trauma associated with a termination decision by allowing a very early termination.

The only wild card I think is your mental state. If you are feeling extremely stressed or very upset then consider just geting the cvs no matter what. You can get it in a week or two and it will be definitive (rather than x odds) and it will be done with. Too much stress is a risk for mom and baby too. :)

alexsmommy
10-05-2009, 02:28 PM
Yes, we knew at least two of my five m/c's were chromosomal and strongly suspected this was the case with the other three. I opted for CVS.
PM me if you would like more details.

Mamma2004
10-05-2009, 02:31 PM
First of all, congratulations!!!!!

I opted not to have an amnio (nor a CVS). After my losses, I feared the "one in two hundred" statistic and decided that an amnio was not for me.

Whatever you decide, I wish you a LONG, healthy, happy pregnancy!

sste
10-05-2009, 02:35 PM
Just wanted to add that the 1:200 or 1:300 statistic is somewhat misleading. If you go to a major academic center or other high volume cvs/amnio provider and you ask them their "numbers," they are often more in the 1:700 or 1:1000 range.

The high rates of complications are due to people who were not adequately trained performing amnio and to a greater extent because its newer and fewer people are adequately trained, cvs.

Though I can certainly understand deciding not to take a risk at all with a procedure and to go with the screen . . .

infocrazy
10-05-2009, 02:38 PM
We had one with DS3 after u/s findings. They all came back normal, and it turned out (at birth) DS3 had a cord issue. We didn't/won't do anything this time around because I feel like although the amnio didn't cause his death, I will always wonder if it sped it up. We had no complications from the amnio itself though.

In your situation, I may decide different, but not being in your shoes, I would probably only do the nuchal trans/bloodwork.

Good luck and congratulations!

Melarina
10-05-2009, 03:17 PM
We did the first trimester screening with both of our babies. I don't have experience with CVS or amnio, but wanted to send a huge congratulations to you!!! Lots of hugs and good wishes.

AnnieW625
10-05-2009, 04:42 PM
You guys are amazing!

I went ahead and got the nerve to call genetic testing back. It turns out that the GC I saw for #2 is going on vacation for two weeks and her first available appt. is the same day as my 12 week appt/scan/blood work appt. So I think we'll just wait and see what happens at that appt. and then see GC if we feel we really need to. This post made me feel so much better about the situation at hand.

ThreeofUs
10-05-2009, 04:55 PM
No btdt, either, but wanted to say a big

CONGRATULATIONS!!!!

That's fantastic news!

melissaflorida
10-05-2009, 07:55 PM
I had CVS done and it was a nightmare experience. The procedure itself went fine, it didn't hurt. I flew from Florida to the premier Dr in Philly. It was the test result...they called with the preliminary results in 3 days and told me congratuations you are having healthy baby girl. THEN 5 days later they called and said the full results are in and it shows a mixed mosciam with Trisomy 18, Trisomy 8 and healthy cells.

I then had to wait and have an Amnio at 16 weeks to rule out the T18 but 8 wouldn't be ruled out with Amnio. In between 12 weeks and 16 I had to get an u/s every 2 weeks looking for any markers for 18 and 8. We had a 50/50 chance the baby was fine as there where healthy cells mixed in and they didn't know if the fetus had the 18 and 8 or not.

It was highly emotional as you can imagine. We didn't find out what was going on until I was 18 weeks along.

They never told me before that CVS checks placenta NOT amniotic fluid and the fetus may NOT have what the placenta has.

Thankfully, my placenta had the 18 and 8 and NOT the baby. We have an healthy girl who is now 5.5yo. But it was an experience that I would want anyone else to avoid.

HTH,

Melissa

mom2binsd
10-05-2009, 09:10 PM
Annie, congrats- positive happy preggo vibes coming your way!!!

I totally understand the struggle with this decision.

After a loss that was a 1 in 40,000 issue we didn't have an amnio or CVS and I was worried up until I gave birth. I mostly wanted to be prepared for any special needs, we were moving right after as well as delivering at a hospital without a NICU...if we hadn't been going through so many issues I think I would have. I had DS in Utah and he ended up in the NICU at another hospital, due to immature lungs at 37 weeks-imagine this 6lb10oz baby in the NICU...he's been going strong ever since.

A bit of history-
After an 18 week D&E due to a very rare teratoma that was discovered at our 17 week ultrasound (we were also going to have an amnio but there was no fluid and really no reason as the fetus had multiple tumors that had prevented proper development), anyway, the docs at UCSD LaJolla who were awesome offered genetic counseling the next time, and as I was 38 when pg with DS we met with them. The triple test wasn't useful due to my age and so they offered an amnio, but at 17 weeks I was so stressed out as DH was contemplating a job change and we were really struggling financially I felt the amnio and my stress would be a bad combination.

MamaKath
10-05-2009, 09:24 PM
Congratulations!!! So exciting!!!

I did not, but would if I have another. I had 2 high risk pregnancies due to complications (preterm labor, low placenta, placental lakes, etc) for mine that came to fruition; before each and after the last I had a total of 5 losses. I had my worst miscarriage though after the birth of my last child. If we are able to have another one, I think I probably would ask for an amnio between my age and that last lost pregnancy.

ohiomom
10-05-2009, 09:36 PM
Many congrats!
Although deep in my heart I knew that DD#2 was going to be fine after she had DS's due date, I still had CVS to be sure since at my age nuchal/blood screening was potentially going to yield a false positive. I just didn't want the anguish and wait. After DS, we did have genetic testing and found DH and I were not carriers, but I still wanted to be sure baby 3 would be ok in terms of most common problems and genetic problem DS had..
Hoping for a wonderful, healthy pregnancy for you!

lchang25000
10-05-2009, 11:43 PM
I don't have any advice, but just wanted to say CONGRATS Annie and Citymama!! Wishing you both a healthy and happy pregnancy!

NancyJ_redo
10-06-2009, 12:57 AM
A huge congratulations to you!!

I had an amnio with #1, CVS with #2 and amnio with #3. We weren't going to do any invasive testing with #3 because it took a while to get pregnant that time and I didn't want to take any unecessary chances, but when we were having a fetal echo done (due to a heart defect with DC#2, we wanted to be sure no issues with #3) they saw markers for Downs and so I decided to have a test done. At that point it was too late for a CVS so we went with an amnio.

I just wanted to mention that if you decide to do a CVS and Kaiser will cover an outside practitioner, I HIGHLY recommend Dr. John Williams at Cedars. He's the guy that people from across the country fly in to see to do a CVS. You can see his bio here http://www.csmc.edu/1792.html, it says he's done over 16,000 CVS - the most of any person West of the Mississippi. I don't know him or have any connection to him, but I was very comfortable going to him for our CVS thanks to his extensive experience.

Good luck in however you decide to proceed.

bubbaray
10-06-2009, 11:20 AM
Yes, I had amnio with DD#1 (PGy#1 after IF treatments) and DD#2 (PGy #3 after 1 m/c and more IF treatments). You can PM me if you want.

I felt very confident with both amnios -- very experienced perinatologists/maternal fetal medicine specialists who both performed thousands of procedures.

If I were having more children (we're d.o.n.e.), I'd have another amnio.

AnnieW625
10-06-2009, 11:58 AM
Thanks again.

MelissaFlorida, oh my what an ordeal. I don't want something like that at all.

Nancy, thanks for the Dr. Williams rec. . Kaiser covered an outside provider for my D&E surgery, which was honestly the best thing to come out of a very sad situation. The staff at the center were absolutely wonderful, and will always have a special place in my heart.

I also talked to DH last night and we both agreed that the least evasive way to go was the best for both of us, and if I still need an amnio then I'll go ahead and get one, but that will be the last resort for us. I was very confident in the dr. who performed the amnio last time so I don't have any issues with that.

jk3
10-06-2009, 12:11 PM
No. We exeprienced 2 losses due to chromosomal abnormalities but we did not do CVS or an amnio with DS2 or DS3. I was too nervous about the chance of miscarriage and we opted for nuchal fold screening, AFP/Quad tests and multiple Level 2 u/s. Had there been indicators, we would've opted for an amnio.