Grand Rounds 4.27 at Monash Medical Student
Monday, March 24, 2008
Kenneth F. Trofatter, Jr., MD, PhD
Many thanks to Jeffrey Leow at
Monash Medical Student for the hard work in putting together a great collection of
Grand Rounds offerings. Thanks also for including a link to my recent post that reviewed
Chromosomal Mosaicism Detected at the Time of Chorionic Villus Sampling. Not only is the decision to have invasive diagnostic testing done during early pregnancy a difficult one, but sometimes the results aren't as straightforward as we would like them to be. Such is the case with chromosomal mosaicism. When counseling prior to performing the procedure is done, these subtleties are often left out of the discussion because "the patient can only digest so much at one time." Admittedly, it is a complex subject, but it does occur in 1-2% of cases, so it is a 'risk' that sooner or later will have to be confronted by any provider who performs CVS. The finding of mosaicism creates incredible uncertainty and anxiety and may lead a pregnant woman to harder decisions, more invasive procedures, and lingering doubt about the baby's outcome, even when follow-up results are reassuring, that can haunt her until after the baby is born...
Labels: chromosomal mosaicism, CVS
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2 Comments:
At Tue Mar 25, 10:06:00 AM 2008,
Anonymous said…
Question on the value of bedrest after amnio:
at 8 weeks I was diagnosed with a placental tear (I had experienced bleeding). I was told to rest in bed for 2 weeks. I completely ignored this recommendation as my understanding is that bedrest has never been proven to help tears heal. I continued working, taking care of my 3 year old, lifting weights, and running 21 miles/week. At 10 weeks, the tear had completely healed. NOW, when my doctor tells me to follow bedrest for 48 hours after amnio, I'm really dubious after my experience with the tear. Is the bed rest REALLY necessary or is it simply a very conservative convention? I have a 3 year old to take care of - bed rest? Yeah right. Please advise. Thanks.
At Wed Mar 26, 07:54:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Anonymous Mar 25: Usually it is more an "unneccesary convention." But, if your doctor is aware of your very active exercise program, his/her caution may be warranted. All of us usually recommend limiting heavy exertional activity for 24-48 hours after amnio simply to help prevent turning a small hole into a BIG hole. With your exercise schedule, you are probably at increased risk for just that sort of thing happening. Bedrest is NOT necessary, but I would recommend taking it easy for a couple of days! Dr T
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