Categories
Herbs & Plants

Epilobium glabellum

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Botanical Name : Epilobium glabellum
Family: Onagraceae
Genus: Epilobium
Kingdom: Plantae
Order: Myrtales

Synonyms:
*Boisduvalia
*Chamaenerion
*Pyrogennema
*Zauschneria

Common Names: Willowherbs;

Habitat : Epilobium glabellum is native to Australia, New Zealand.It grows on the loamy soils, flats and hillsides in eastern Australia.

Description:
Epilobium glabellum is an evergreen Perennial flowering plant, growing to 0.2 m (0ft 8in) by 0.2 m (0ft 8in). It is in leaf 12-Jan It is in flower from Jul to August. The flowers are hermaphrodite (have both male and female organs) and are pollinated by Bees….CLICK & SEE THE PICTURES:

Cultivation:
Prefers a well-drained but moisture retentive soil in a sunny position or in partial shade. Succeeds in most soils. Possibly hardy to about -15°c. Plants are semi-evergreen.

Propagation:
Seed – sow early spring in situ or as soon as the seed is ripe. Division in spring or autumn. Very easy, larger clumps can be replanted direct into their permanent positions, though it is best to pot up smaller clumps and grow them on in a cold frame until they are rooting well. Plant them out in the spring.
Edible Uses: Young leaves and shoots – cooked and eaten.

Medicinal Uses: The herb is used is as a herbal supplement in the treatment of prostate, bladder (incontinence) and hormone disorders.

Other Uses: A useful ground cover plant.

Disclaimer : The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplement, it is always advisable to consult with your own health care provider.

Resources:
https://en.wikipedia.org/wiki/Epilobium
http://www.pfaf.org/user/Plant.aspx?LatinName=Epilobium+glabellum

Categories
Herbs & Plants

Gypsophila struthium

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Botanical Name: Gypsophila struthium
Family: Caryophyllaceae
Genus: Gypsophila
Kingdom: Plantae
Order: Caryophyllales

Common Name: Egyptian  Soapwort,  Baby’s-breath

Habitat : Gypsophila struthium is native to Eurasia, Africa, Australia, and the Pacific Islands.

Description:, 
Gypsophila struthium is a perennial herbaceous plant with a stem 1 to 2 feet in height.The leaves are variable in shape. The inflorescence is usually a cyme or a thyrse, branching intricately. Each small flower has a cup-like calyx of white-edged green sepals containing five petals in shades of white or pink. The fruit is a rounded or oval capsule opening at valves. It contains several brown or black seeds which are often shaped like a kidney or a snail shell.

CLICK & SEE THE PICTURES : 

The root is generally in lengths of 4 to 6 inches, 1/2 to 1 1/2 inches in diameter; colour a yellowish white, furrowed down its length externally with lighter places where the cortex has been rubbed. The section is of a radiate and concentric structure. Taste bitter, then acrid; odour slight; powder irritating to the nostrils. This variety is rarely used medicinally, the Soapwort (Saponaria officinalis) being used as a substitute. The flowers are hermaphrodite (have both male and female organs)
Cultivation :
Requires a sunny position and a deep soil. Lime tolerant. Grows well in a dryish soil.
Propagation :
Seed – we have no information for this species but suggest sowing the seed in a greenhouse in spring. When they are large enough to handle, prick the seedlings out into individual pots and, if growth is sufficient, plant them out into their permanent positions in the summer. If the plants are too small to plant out, grow them on in the greenhouse for their first winter and then plant them out in late spring or early summer. Division in spring or autumn. Larger clumps can be replanted direct into their permanent positions, though it is best to pot up smaller clumps and grow them on in a cold frame until they are rooting well. Plant them out in the spring. Basal cuttings before the plant flowers. Harvest the shoots when they are about 10cm long with plenty of underground stem. Pot them up into individual pots and keep them in light shade in a cold frame or greenhouse until they are rooting well. Plant them out in the summer. Root cuttings.
Medicinal Uses:
Alterative; Diaphoretic; Purgative; Skin; Tonic.

Tonic, diaphoretic, alterative. A valuable remedy in the treatment of syphilitic, scrofulous and cutaneous diseases, also in jaundice, liver affections, rheumatism and gonorrhoea, the decoction is generally used. Saponin is produced from this plant. Although rarely used, this species can be employed in many of the same ways as soapwort, Saponaria officinalis. It is a valuable remedy, used as an external wash, for the treatment of many skin diseases.

Other Uses : The plant contains saponins. This may be used as soap substitute.

Known Hazards: Although no mention has been seen for this species, at least one member of this genus has a root that is rich in saponins. Although toxic, these substances are very poorly absorbed by the body and so tend to pass through without causing harm. They are also broken down by heat so a long slow baking can destroy them. Saponins are found in many plants, including several that are often used for food, such as certain beans. It is advisable not to eat large quantities of food that contain saponins. Saponins are much more toxic to some creatures, such as fish, and hunting tribes have traditionally put large quantities of them in streams, lakes etc in order to stupefy or kill the fish.

Disclaimer : The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplement, it is always advisable to consult with your own health care provider.

Resources:
https://en.wikipedia.org/wiki/Gypsophila
http://www.botanical.com/botanical/mgmh/s/soroeg62.html
http://www.pfaf.org/user/Plant.aspx?LatinName=Gypsophila+struthium

Categories
Ailmemts & Remedies

Paget’s Disease of Bone

Definition:
Paget’s disease of bone causes affected bones to become enlarged and misshapen. Our bones are living tissue, and our bodies are constantly breaking down old bone and replacing it with new bone. In Paget’s disease, however, old bone is broken down and replaced at a faster rate than normal. The new bone is larger and weaker than normal bone.

Click to see the picture


Click to see the picture

Paget’s disease can occur in any bone in the body, but it is most common in the pelvis, spine, skull, and leg bones. It may occur in just one bone or in several bones, but it does not affect the entire skeleton or spread from affected bones to normal bones. Common symptoms include pain, misshapen bones, and a greater chance of broken bones.

Decisions about treating Paget’s disease can be complicated because: 1) no two people are affected in exactly the same way by the disease, and 2) it is sometimes difficult to predict whether a person with Paget’s disease who shows no signs of the disorder will develop symptoms or complications, such as a bone fracture, at a later date. Although there is no cure for Paget’s disease, medications (bisphosphonates and calcitonin) can help control the disorder and lessen pain and other symptoms. Paget’s disease experts recommend that these medications be taken by people with Paget’s disease who: have bone pain, headache, back pain, or a nerve-related symptom (such as “shooting” pains in the leg) that is directly associated with the disease; have elevated levels of serum alkaline phosphatase (SAP) in their blood; display evidence that a bone fracture will occur; require pretreatment therapy for affected bones that require surgery; have active symptoms in the skull, long bones, or vertebrae (spine); have the disease in bones located next to major joints, placing them at risk of developing osteoarthritis; develop a rare condition called hypercalcemia that occurs when a person with several bones affected by Paget’s disease and a high SAP level is immobilized.

Today’s medications, especially when started before complications begin, are often successful in controlling the disorder. Paget’s disease is rarely diagnosed in people less than 40 years of age. Women are more commonly affected than men. Prevalence of Paget’s disease ranges from 1.5 to 8.0 percent, depending on age and country of residence. Prevalence of familial Paget’s disease (where more than one family member has the disease) ranges from 10 to 40 percent in different parts of the world.[citation needed] Because early diagnosis and treatment is important, after age 40, siblings and children of someone with Paget’s disease may wish to have an alkaline phosphatase blood test every two or three years. If the alkaline phosphatase level is above normal, other tests such as a bone-specific alkaline phosphatase test, bone scan, or X-ray can be performed.

Named for Sir James Paget (1814–1899)

Symptoms:
Most people who have Paget’s disease of bone experience no symptoms. When symptoms do occur, the most common complaint is bone pain. The disease may affect only one or two areas of your body, or may be widespread. Your signs and symptoms, if any, will depend on the part of your body that’s affected, including:

*Pelvis. Paget’s disease of bone in the pelvis can cause hip pain.

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*Skull. An overgrowth of bone in the skull can cause hearing loss or headaches.

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*Spine. If your spine is affected, nerve roots can become compressed. This can cause pain, tingling and numbness in an arm or leg.

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*Leg. As the bones weaken, they may bend — causing you to become bow-legged. Enlarged and misshapen bones in your legs can put extra stress on nearby joints, which may cause wear-and-tear arthritis in your knee or hip.

 CLICK & SEE

 Click to see the pictures

Other common  Symptoms are:

•Bone and joint pain.
•Deformity of a bone such as bowing of the leg, skull enlargement or curvature of the spine.
•Muscle weakness due to bones pressing on nerves.
•Bone fractures resulting from minor injury (bone affected by Paget’s disease has a disorganised structure and is mechanically weak).
•Arthritis (when Paget’s affects bone around a joint).
•Deafness, vision disturbance, dizziness and tinnitus when enlargement of skull bones puts pressure on vital nerves.
•A “hot spot” over an area of affected bone due to high blood supply.
Causes:
Even after you’ve reached your full height, your bones don’t stop growing. Bone is living tissue engaged in a continual process of renewal. During this constant process called remodeling, old bone is removed and replaced by new bone. Paget’s disease of bone disrupts this process.

Early in the course of the disease, old bone starts breaking down faster than new bone can be built. Over time, your body responds by generating new bone at a faster than normal rate. This rapid remodeling produces bone that’s softer and weaker than normal bone, which can lead to bone pain, deformities and fractures.

Scientists haven’t identified a cause of Paget’s disease of bone, though they have discovered several genes that appear to be linked to the disorder.

Some scientists believe Paget’s is related to a viral infection in your bone cells that may be present for many years before problems appear. Hereditary factors seem to influence whether you’re susceptible to the disease.
Risk Factors:
*Age. People older than 40 are the most likely to develop Paget’s disease of bone.

*Sex. Men are more commonly affected than are women.

*National origin. Paget’s disease of bone is more common in people of Anglo-Saxon descent.

*Family history. If you have a close relative who has Paget’s disease of bone, you are much more likely to develop the condition yourself.

Complications:
In most cases, Paget’s disease of bone progresses slowly. The disease can be managed effectively in nearly all people. Possible complications include:

*Fractures. Bones affected by Paget’s disease are large and dense, but also weak and brittle. This makes them more prone to fractures. More blood vessels are created in these deformed bones, so they bleed more during repair surgeries.

*Osteoarthritis. Misshapen bones can increase the amount of stress on nearby joints, which can cause osteoarthritis.

*Heart failure. Unusually extensive Paget’s disease may force your heart to work harder to pump blood to the affected areas of your body. In people with pre-existing heart disease, this increased workload can lead to heart failure.Bone cancer. Bone cancer occurs in less than 1 percent of people with Paget’s disease.
Diagnosis:
DiagnosisPaget’s disease may be diagnosed using one or more of the following tests:

*Pagetic bone has a characteristic appearance on X-rays. A skeletal survey is therefore indicated.

*An elevated level of alkaline phosphatase in the blood in combination with normal calcium, phosphate, and aminotransferase levels in an elderly patient are suggestive of Paget’s disease.

*Bone scans are useful in determining the extent and activity of the condition. If a bone scan suggests Paget’s disease, the affected bone(s) should be X-rayed to confirm the diagnosis.
Associated medical conditions:
Paget’s disease may lead to other medical conditions, including:

*Arthritis may be caused by bowing of long bones in the leg, distorting alignment and increasing pressure on nearby joints. In addition, pagetic bone may enlarge, causing joint surfaces to undergo excessive wear. In these cases, pain may be due to a combination of Paget’s disease and osteoarthritis.

*Loss of hearing in one or both ears may occur when Paget’s disease affects the skull and the bone that surrounds the inner ear. Treating the Paget’s disease may slow or stop hearing loss. Hearing aids may also help.

*Cardiovascular disease can result from severe Paget’s disease (i.e. with more than 15% skeletal involvement). Arteriovenous connections can often form in the bone, and so the heart has to work harder (pump more blood) to ensure adequate oxygen supply to the tissues. This increase in cardiac output can lead to calcification of the aortic valve, and the resulting aortic stenosis causes left ventricular hypertrophy and eventually high-output congestive failure.

*Kidney stones are somewhat more common in patients with Paget’s disease.

*Pagetic bone can cause nervous system problems, such as pressure on the brain, spinal cord, or nerves, and reduced blood flow to the brain and spinal cord.

*Rarely, Paget’s disease is associated with the development of osteosarcoma (malignant tumor of bone).
*When there is a sudden onset or worsening of pain, sarcoma should be considered.

*When Paget’s disease affects the facial bones, the teeth may become loose. Disturbance in chewing may occur.

*Rarely, when the skull is involved, the nerves to the eye may be affected, causing some loss of vision.

*Angioid streaks may develop, possibly as a result of calcification of collagen or other pathological deposition.

Paget’s disease is not associated with osteoporosis. Although Paget’s disease and osteoporosis can occur in the same patient, they are different disorders. Despite their marked differences, several treatments for Paget’s disease are also used to treat osteoporosis.

Treatment:
Endocrinologists (internists who specialize in hormonal and metabolic disorders), rheumatologists (internists who specialize in joint and muscle disorders), orthopedic surgeons, neurologists, and otolaryngologists are generally knowledgeable about treating Paget’s disease, and may be called upon to evaluate specialized symptoms.

Drug therapy
The goal of treatment is to relieve bone pain and prevent the progression of the disease. The U.S. Food and Drug Administration has approved the following treatments for Paget’s disease:

Bisphosphonates
Five bisphosphonates are currently available. In general, the most commonly prescribed are: risedronic acid (Actonel), alendronic acid (Fosamax) and pamidronic acid (Aredia). Etidronic acid (Didronel) and other bisphosphonates may be appropriate therapies for selected patients, but are less commonly used. As a rule, bisphosphonate tablets should be taken with 200-250 mL (6–8 oz) of tap water (not from a source with high mineral content) on an empty stomach. None of these drugs should be used by people with severe kidney disease.

*Etidronate disodium (Didronel) in tablet form is available in 200–400 mg doses. The approved regimen is once daily for six months; the higher dose (400 mg) is more commonly used. No food, beverage, or medications should be consumed for two hours before and after taking. The course should not exceed six months, but repeat courses can be given after rest periods, preferably of three to six months duration.

*Pamidronate disodium (Aredia) in intravenous form: the approved regimen uses a 30 mg infusion over four hours on each of three consecutive days, but a more commonly used regimen is 60 mg over two to four hours for two or more consecutive or nonconsecutive days.

*Alendronate sodium (Fosamax) is given as tablets of 40 mg once daily for six months; patients should wait at least 30 minutes after taking before eating any food, drinking anything other than tap water, taking any medication, or lying down (patient may sit).

*Tiludronate disodium (Skelid) in two tablets of 200 mg are taken once daily for three months; they may be taken any time of day, as long as there is a period of two hours before and after resuming food, beverages, and medications.

*Risedronate sodium (Actonel) as a 30 mg tablet taken once daily for 2 months is the prescribed regimen; patients should wait at least 30 minutes after taking before eating any food, drinking anything other than tap water, taking any medication, or lying down (patient may sit).

*Zoledronic acid (Reclast, Aclasta) is given as an intravenous infusion; a single dose (5 mg over 15 minutes) is effective for two years.

Calcitonin
*Miacalcin is administered by injection; 50 to 100 units daily or three times per week for 6–18 months. Repeat courses can be given after brief rest periods. Miacalcin may be appropriate for certain patients, but is seldom used. The nasal spray form of this drug is not approved for the treatment of Paget’s disease.

Diet and regular exercise:
In general, patients with Paget’s disease should receive 1000–1500 mg of calcium, adequate sunshine, and at least 400 units of vitamin D daily. This is especially important in patients being treated with bisphosphonates; however, taking oral bisphosphonates should be separated from taking calcium by at least two hours, because the calcium can inhibit the absorption of the bisphosphonate. Patients with a history of kidney stones should discuss calcium and vitamin D intake with their physicians.

Exercise is  most important in maintaining skeletal health, avoiding weight gain, and maintaining joint mobility. Since undue stress on affected bones should be avoided, patients should discuss any exercise program with their physicians before beginning.
Prognosis:
The outlook is generally good, particularly if treatment is given before major changes in the affected bones have occurred. Any bone or bones can be affected, but Paget’s disease occurs most frequently in the spine, skull, pelvis, femur, and lower legs. In general, symptoms progress slowly, and the disease does not spread to normal bones. Treatment can control Paget’s disease and lessen symptoms, but is not a cure. Osteogenic sarcoma, a form of bone cancer, is an extremely rare complication that occurs in less than one percent of all patients.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://en.wikipedia.org/wiki/Paget’s_disease_of_bone
http://www.bbc.co.uk/health/physical_health/conditions/pagets1.shtml
http://www.endotext.org/parathyroid/parathyroid15/parathyroid15.html
http://www.mayoclinic.com/health/pagets-disease-of-bone/DS00485
http://www.surgeongeneral.gov/library/bonehealth/chapter_3.html
http://www.sciencephoto.com/media/260576/enlarge

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Categories
Herbs & Plants

Allemanda cathartica

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Botanical Name :Allemanda cathartica Linn
Family: Apocynaceae
Genus: Allamanda
Species: A. cathartica
Kingdom: Plantae
Order: Gentianales

Syn.:  Allamanda cathartica Linn, Allamanda hendersonii Bull, Allamanda augustifolia Pohl

Common Names: :Golden trumpet, Harkakra, Campenilla, The cup of gold, Willow leaved Allamanda, Haladilu, Kolaambi, Jaharisontakka,.Kampanero (Tag.),Campanilla (Span., Tag.) Kampanero (Tag.) ,Kampanilya (Tag.) ,Kompanaria (Tag.), Yellow allamanda (Engl.) ,Yellow bell (Engl.) ,Golden trumpet (Engl.)  Cherries jubilee allamanda (Engl.) Huang ying (Chin.)

Local names: Campanilla (Sp., Tag.); kampanero (Tag.); kompanaria (Tag.); golden trumpet (Engl.).

Habitat :Native from Brazil.   Allemanda cathartica  was introduced from tropical America and is now cultivated for ornamental purposes. It is occasionally semi-established in thickets near dwellings or settlements.

Description:
This plant is a smooth or somewhat hairy shrub 2 to 4 meters in height. The leaves grow in whorls of three or four, though the uppermost ones may be scattered, and are lanceolate or oblanceolate, 8 to 12 centimeters long, 2.5 to 4 centimeters wide, and pointed at both ends. The yellow flowers are shortly stalked. The calyx-teeth are green, somewhat spreading, lanceolate, and 1 to 1.5 centimeters long. The corolla is about 7 centimeters long; the slender part os the tube being 3 centimeters long; the tube is then inflated up to 2 centimeters in diameter; the lobes are ovate or oblong-ovate, spreading, rounded, and about 2 centimeters long.
Its large flowers are very fragrant. This South American plant is thought to blossom best in full sunshine, and well drained soil.
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Constituents: Phytochemical studies revealed the main constituents to be alkaloids, flavonoids, saponins and carbohydrates.
The whole plant is reported to be poisonous.Contains allamandin, a toxic iridoid lactone.As the name implies, the leaves, roots and flowers may be used in preparing a powerful cathartic. Milky sap is considered antibacterial, possibly anticancer.

Medicinal Uses:
Parts utilized: Leaves and bark.

Purgative, cathartic with hydrogogue effect, healing, diuretic.
In the Philippines, whole plant is considered poisonous.

Folkloric
*The plant draws its name from Allamand, who made the plant known a century and a half ago, who used a cathartic infusion of the leaves for colic.
*Infusion of leaves in moderate doses is an excellent cathartic; in considerable doses, it is purgative and a violent emetic.
*The bark and latex in small doses are considered cathartic; in large doses, poisonous.
*Decoction of the bark is a hydragogue; infusion of leaves is cathartic.
*Decoction of leaves in small doses used as antidote for poisoning.
*Extract of leaves used for colic and as laxative; in large doses causes diarrhea and vomiting.
*In Trinidad, used for treating malaria and jaundice.
*In Guiana, the latex is used as a purgative and employed for colics.
*In Surinam, the plant is used as a cathartic.

This plant is cited in Flora Brasiliensis by Carl Friedrich Philipp von Martius.It is mainly used to treat malaria.

Disclaimer:
The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplements, it is always advisable to consult with your own health care provider.

Studies
:
• Purgative Effect: Findings suggest AC leaf extracts can elicit a purgative effect by increasing intestinal motility, in part, via muscarinic receptor activaton.
Wound Healing: The study of aqueous extract showed significant wound healing activity in wound models studies with decrease epithelialisation time, high skin breaking strength, and increase in granulation tissue weight and hydroxyproliing content. The Allamanda leaf extract possesses better wound healing activity than the Laurus nobilis.
• Reversible Antifertility Effect: The study on the oral administration of aqueous leaf extract of AC showed reversible suppression of fertility in male mice – organ weight,, testosterone levels, sperm parameters among others – without detectable toxic effects.
• Antidermatophytic: Plumeride, an active principle isolated from the leaves of AC showed strong fungitoxicity against some dermatophytes causing dermatomycosis to both humans and animals.
• Purgative Effect : Study showed the aqueous extract of leaves of Ac could produce a purgative effect by increasing intestinal motility, partly through muscarinic receptor activation.
Anti-Proliferative / Cytotoxic: Study evaluated the anti-proliferative effect of A. blanchetti and A. schottii on K562 leukemic cells. Results showed both plants exhibited cytostatic and cytotoxic activity, the most active were located in the roots.
• Antimicrobial: Study of leaf extract of A. cathartic showed antimicrobial activity – the chloroform extract showed significant activity against Shigella dysenteriae, moderate activity against B subtilis, P aeruginosa and a niger.
Bioactive Iridoids / Cytotoxic: Study of ethanol extract of A cathartica and H fallax isolated a weakly cytotoxic isoplumericin and plumericin.

Resources:

Click to access campanilla.pdf

http://en.wikipedia.org/wiki/Allamanda_cathartica
http://www.stuartxchange.org/Kampanilya.html
:

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Categories
Diagnonistic Test

Chorionic Villus Sampling

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Definition
Chorionic villi are small structures in the placenta that act like blood vessels. These structures contain cells from the developing fetus. A test that removes a sample of these cells through a needle is called chorionic villus sampling (CVS).Chorionic villus sampling (CVS) is the removal of a small piece of placenta tissue (chorionic villi) from the uterus during early pregnancy to screen the baby for genetic defects
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CVS answers many of the same questions as amniocentesis about diseases that the baby might have. Diseases that can be diagnosed with CVS include Tay-Sachs, sickle cell anemia, cystic fibrosis, thalassemia, and Down syndrome. (Rh incompatibility and neural tube defects, however, can be diagnosed only through amniocentesis.) CVS can be done earlier in pregnancy than amniocentesis and can be done when there is not enough amniotic fluid to allow amniocentesis. However, it has some extra risks when compared with amniocentesis.

Why the Test is Performed
The test is a way of detecting genetic disorders. The sample is used to study the DNA, chromosomes, and enzymes of the fetus. It can be done sooner than amniocentesis, about 10 to 12 weeks after your last menstrual period. Test results take about 1 to 2 weeks, whereas amniocentesis results may take longer.

Chorionic villus sampling does not detect neural tube defects. If neural tube defects or Rh incompatibility are a concern, an amniocentesis will be performed.

This test can usually not diagnose problems in the way the body forms.

How the Test is Performed
CVS can be done through the cervix (transcervical) or through the abdomen (transabdominal). The techniques are equally safe when done by a provider with experience, although miscarriage rates are slightly higher when done through the cervix. The health care provider will use ultrasound to pick the safest approach and as a guide during sampling.

An abdominal ultrasound is performed to determine the position of the uterus, the size of the gestational sac, and the position of the placenta within the uterus. Your vulva, vagina, cervix, and abdomen are cleaned with an antiseptic such as Betadine.

The transcervical procedure is performed by inserting a thin plastic tube through the vagina and cervix to reach the placenta. The provider uses ultrasound images to help guide the tube into the appropriate area and then removes a small sample of chorionic villus tissue.

The transabdominal procedure is performed by inserting a needle through the abdomen and uterus and into the placenta. Ultrasound is used to help guide the needle, and a small amount of tissue is drawn into the syringe.

The sample is placed in a dish and evaluated in a laboratory.

What happens when the test is performed.
There are two ways that your doctor can perform CVS. Some patients have the sampling done through the vagina and cervix. Most patients have the sampling done through the abdominal wall. For both types of sampling, you lie on your back on an examination table and the doctor uses ultrasound to locate the fetus and the placenta.

If the sampling is to be done through the vagina and cervix, you place your feet in footrests and bend your knees up, as you would for a pelvic examination. A speculum (a device that looks like a duck-bill that can be opened and closed) is used to open the vagina so that your doctor can see inside. A long tube, much narrower than a straw, is inserted through the cervix and moved forward while your doctor watches on the ultrasound until it is next to the fetal side of the placenta. A small sample of the lining around the fetus is then pulled into the tube for testing.

If the sampling is to be done through the abdominal wall, your lower abdomen is cleaned with an antibacterial soap. In some cases, the doctor uses a small needle to inject a numbing medicine just under the skin, so that you do not feel the sampling needle. (Because the sampling needle does not cause much more stinging than the numbing medicine itself, not every doctor includes this step.) A hollow needle several inches long is inserted through the skin and muscle of the abdomen and through the wall of the uterus, to the edge of the placenta. This needle is held in place as a guide needle. A narrower needle is then inserted through the first needle and is rotated and moved inward and outward a number of times while a sample is collected into an attached syringe.

The fetal heart tones and the mother’s blood pressure and heart rate are checked at the beginning and end of the procedure. The whole procedure takes close to 30 minutes.

How to Prepare for the Test.
CVS can be done between the 10th and 13th weeks of pregnancy. Tell your doctor ahead of time if you have ever had an allergic reaction to lidocaine or the numbing medicine used at the dentist’s office.

Your health care provider will explain the procedure, its risks, and alternative procedures such as amniocentesis. Genetic counseling is recommended prior to the procedure. This will allow you to make an unhurried, informed decision regarding options for prenatal diagnosis.

You will be asked to sign a consent form before this procedure, and you may be asked to wear a hospital gown.

The morning of the procedure you may be asked to drink fluids and refrain from urinating to fill your bladder, which allows adequate visualization so the sample may be taken.

How the Test Will Feel
The ultrasound doesn’t hurt. A clear, water-based conducting gel is applied to the skin to help with the transmission of the sound waves. A handheld probe called a transducer is then moved over the area. In addition, your health care provider may apply pressure on your abdomen to find the position of your uterus.

The antiseptic cleansing solution will feel cold at first nd may irritate your skin if not washed off after the procedure. Some people are allergic to Betadine. Notify your health care provider if you are allergic to Betadine or if you have any other allergies.

Some women say the vaginal approach feels like a Pap smear with some discomfort and a feeling of pressure. There may be a small amount of vaginal bleeding following the procedure.

An obstetrician can perform this procedure in about 5 minutes, after the preparation

Risk Factors:

The risks of CVS are only slightly higher than those of an amniocentesis.

Possible complications include:

* Bleeding
* Infection
* Miscarriage
* Rh incompatibility in the mother
* Rupture of membranes

Signs of complications include:

* Excessive bleeding
* Excessive vaginal discharge
* Fever

The risk of miscarriage and other complications from CVS is slightly higher than the risk from amniocentesis, although some parents feel that it is worth the extra risk to be able to makedecisions earlier in the pregnancy if the results show the baby has a health problem. There have also been some reports that suggest there is a very small risk of birth defects (abnormal limbs) in the fetus.

One particular difficulty with this test is that due to variability in the cells of the placenta (called mosaicism), occasionally you can have an abnormal test result even if the baby is normal and healthy. This might lead you to make decisions about pregnancy termination that you would not have made if you had better information.

Some women have vaginal bleeding after the procedure. Infection is uncommon.

Report any signs of complications to your health care provider.

CVS may also cause limb problems in the fetus. This risk appears to be very low (1 in 3,000) when CVS is performed after 10 weeks gestational ag

Time to know the  result of the test
Chromosome analysis of the sample takes two weeks or more. The results of some tests may be available sooner.

RESULTS:-

Normal Results
A normal result means there are no signs of any genetic defects. However the test could miss some genetic defects.

Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

What Abnormal Results Mean

An abnormal result may be a sign of more than 200 disorders, including:

* Down syndrome
* Hemoglobinopathies
* Tay-Sachs disease

Considerations
If your blood is Rh negative, you may receive RhoGAM to prevent Rh incompatibility.
You will receive a follow-up ultrasound 2 to 4 days after the procedure to make sure the pregnancy is proceeding normally.

Resources:
https://www.health.harvard.edu/fhg/diagnostics/chorionic-villus-sampling.shtml
http://www.nlm.nih.gov/medlineplus/ency/article/003406.htm

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