You asked

Can I minimise the risk of amnio or CVS testing?

Deciding which antenatal test to have is a very personal decision. You might choose to have CVS if you have reason to believe there may be a problem with the foetus and you want an answer as quickly as possible. If your only reason for concern is your age, you might choose to wait for an amniocentesis to minimise the risk of miscarriage.

Amniocentesis is an invasive procedure. There is a small risk, less than one in 1,000 women will develop serious infections or other complications. About one in 100 women miscarry as a direct result of amniocentesis. Some experienced clinicians may have lower rates of miscarriage following the procedure, so it is worth the time to do some research and find out what the rate is for your hospital. Some mums to be have travelled abroad to find clinics offering lower rates of miscarriage.  Amniocentesis is usually carried out in the third trimester because there is a lower risk of complications and is not linked to premature labour.

The procedure is best avoided if you have been tested HIV positive, since there is an increased risk of the virus being transmitted to your baby, especially in the third trimester. But if you feel that the amniocentesis is necessary, you will need highly active antiretroviral therapy (HAART) during the procedure to reduce the risk of transmission of the virus to the baby.

It was once thought that CVS testing resulted in limb defects, but only if the testing occurred prior to ten weeks gestation.  It is now believed that such problems are extremely rare and may not necessarily be connected to CVS. However, most units will only carry out CVS after ten weeks because of the possible risk.

As with amniocentesis, CVS is best avoided if you are HIV positive. There is that same increased risk of transmission of the virus to your baby during the procedure. You will require treatment with HAART if you do have the procedure to reduce the risk of transmission of the HIV virus to the baby. There is no evidence of an increased risk of disease transmission to your baby by CVS, if you have hepatitis B or C.

Consider these facts before you decide: about two out of every one hundred women will miscarry as a result of having CVS as compared to about one in every one hundred resulting in miscarriage after amniocentesis.  The decision is yours – CVS, amniocentesis or neither.
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