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Wednesday, June 19, 2013
No, this is not necessary.
Genetic testing is routinely offered to women who will be older than 35 years at time of delivery because the risk of Down's Syndrome and other chromosomal problems increase with maternal age. Either Chorionic Villus Sampling (CVS) or amniocentesis can detect the baby's sex, the number of chromosomes and any large defects in the chromosomes. The difference in the two methods comes down to when they are done and the risk.
CVS is performed between 10 and 12 weeks of pregnancy and involves taking a sample of the placenta for analysis. Since it is performed earlier in the pregnancy, results are available sooner, but the risk of miscarriage from the procedure is approximately 1%. There has been some controversy over whether CVS causes defects in the fetus's limbs, but those cases are seen if CVS is performed at less than 10 weeks of pregnancy.
Amniocentesis can be performed anytime after 14 weeks and has a procedure-related miscarriage rate of 1 in 250-300. The procedure involves taking about 2 tablespoons of amniotic fluid, which is composed of fetal cells and fetal urine, with an ultrasound guided needle. The fluid is typically analyzed for either chromosomes or for fetal lung maturity. Amniotic fluid will sometimes leak after an amniocentesis, but we believe that it does not occur after each procedure because the hole is small and the hole can "re-seal." Since the procedure is performed later in pregnancy, the results come later.
There is no right or wrong answer of which procedure, if any, is best for you. The majority of women opt for amniocentesis, given the lower complication rate.
The American Academy of Pediatrics has approved the use of oral contraceptives for use in breastfeeding mothers. However, it is important to note that oral contraceptives may reduce the amount of milk produced by the breastfeeding woman. The earlier in the breastfeeding experience the oral contraceptives are started the greater the effect on the decreased milk production. Prior to beginning oral contraceptives it is important to have your milk well established, and that your baby is gaining weight. If you take oral contraceptives it is important that your baby's health care provider be aware of this so that weight gain can be closely monitored. Also, discuss with your health care provider that you are breastfeeding so that the correct type of oral contraceptive can be prescribed for you.
Hormonal contraception that does not contain estrogen (the minipill, Depo Provera, etc.) is not felt to decrease milk production.
Last Reviewed: May 28, 2002
Arthur T Ollendorff, MD
Associate Professor of Obstetrics and Gynecology
College of Medicine
University of Cincinnati