CVS & PE

Hi Liz (& everyone else too!)

Sorry haven't been on much lately, but finally have a mo... And a strange question for you too!
We have decided to TTC#3 (yes, probably mad to), and due to Mairi having cystic fibrosis we want to have a CVS test at 11 weeks. My lovely obstetrician from Mairi's pregnancy (who looked after us very well) has put everything into place for this to happen if & when I fall pregnant, which in a way in a relief. She also wants me ideally to start aspirin again from as soon as we get a positive pregnancy test. However, she then called to say we might not be able to start aspirin until after the CVS due to risks of bleeding- but she is seeking more advice on this.

Has anyone else had a CVS while on aspirin?

And stupidly I googled CVS & PE and found some research showing that hacing a CVS & the related disruption to the placenta could increase PE risk. So now of course I've started to worry, even though I'm not even pregnant yet!!

Any advice would be most welcome!

Thank you- hope you & your families are well,
Annika xx

Hi Annika,

Good to hear from you again!

This is info I found on CVS & PE risks -

Chorionic villus sampling and risk for hypertensive disorders of pregnancy.Adusumalli J, Han CS, Beckham S, Bartholomew ML, Williams J 3rd.
Division of Maternal-Fetal Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA. Jasvant.adusumalli@cshs.org

OBJECTIVE: This study was undertaken to evaluate the relationship between chorionic villus sampling at 10-13 weeks' gestational age and hypertensive disorders of pregnancy. STUDY DESIGN: The prevalence of hypertensive disorders of pregnancy in women with singleton gestations, undergoing transcervical or transabdominal chorionic villus sampling between 10 weeks 0 days' and 13 weeks 6 days' gestational age was compared with that of control women with singleton gestations having first-trimester screening with nuchal translucency and biochemistry between 11 weeks 0 days' and 13 weeks 6 days' gestational age. Patients having invasive prenatal diagnosis (chorionic villus sampling or amniocentesis) were excluded from the control group. All patients delivered at Cedars-Sinai Medical Center. RESULTS: There were 1540 women who had chorionic villus sampling and 840 controls. Hypertensive disorders of pregnancy were diagnosed in 76 (4.9%) patients in the chorionic villus sampling group and in 37 (4.4%) of the controls (chi2 = 0.34, P = .31). CONCLUSION: Chorionic villus sampling at 10 to 13 weeks' gestational age does not appear to increase the overall risk for hypertensive disorders of pregnancy. However, there appears to be an association between chorionic villus sampling and severe hypertensive disorders including severe preeclampsia, eclampsia, and hemolysis, elevated liver enzymes, and low platelet count syndrome.

PMID: 17547909 [PubMed - indexed for MEDLINE]

As for aspirin & CVS the information I have is sketchy.
Obviously any form of anti-coagulant therapy will slightly increase the risk of miscarriage but the risk of PE is also there too & becomes a bit of a balancing act.
From the very sketchy reports I have seen, it seems that women are taking aspirin or even heparin before CVS.
With heparin the dose is stopped a few days prior to CVS testing and blood taken to reveal the clotting times. With aspirin it is the same but the dose stopped for longer. Either way clotting agents were available should there be any question that a bleed was likely in order to 'thicken' the blood up again until the wounds had healed & the risks reduced.

I hope this helps. Good luck & hope to hear happy news soon!
Warm wishes to you all,
Liz