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Changes in circulating alphafetoprotein and human chorionic gonadotrophin following chorionic villus sampling
1Department of Obstetrics and Gynaecology, School of Medicine, University College, London, U.K.
Summary
Chorionic villus sampling (CVS) can cause Rhesus sensitization in mothers, necessitating Anti-D prophylaxis. Post-CVS alphafetoprotein (AFP) levels rise but do not impact pregnancy outcomes.
Area of Science:
- Maternal-fetal medicine
- Prenatal diagnostics
- Immunology
Background:
- Chorionic villus sampling (CVS) is a common first-trimester diagnostic procedure.
- CVS carries a risk of fetomaternal hemorrhage, potentially leading to Rhesus sensitization.
- Rhesus sensitization can cause spontaneous abortion in Rhesus-negative mothers.
Purpose of the Study:
- To evaluate the impact of CVS on maternal Rhesus status.
- To assess changes in fetal markers like alphafetoprotein (AFP) and human chorionic gonadotropin (hCG) after CVS.
- To provide recommendations for managing Rhesus-negative mothers undergoing CVS.
Main Methods:
- Serial maternal blood sampling to monitor AFP and hCG levels.
- Assessment of Rhesus sensitization risk following CVS.
- Review of pregnancy outcomes in relation to maternal Rhesus status and CVS.
Main Results:
- CVS can lead to fetomaternal hemorrhage and Rhesus sensitization in Rh-negative mothers.
- Transient elevations in AFP levels are observed post-CVS, but do not correlate with later pregnancy outcomes.
- hCG level alterations are minimal and variable.
- Anti-D prophylaxis is recommended for non-sensitized Rh-negative mothers post-CVS.
Conclusions:
- CVS requires careful management in Rhesus-negative mothers, including Anti-D prophylaxis.
- The procedure may be contraindicated in already sensitized Rh-negative patients.
- Monitoring AFP and hCG levels post-CVS provides limited predictive value for pregnancy outcome.