Kemusykilan psl DNA Test..

Lepas buat DNA Test atau CVS minggu lepas, ada beberapa perkara yg mengganggu fikiran ni. Kalu ikutkan aku dah malas nk ulang alik di HUKM lg. Dan test tu akan menjadi BD yg terakhir utk aku. Tapi.... beberapa perkara mcm tak kene atau mereka ni tak selaras antara satu sama lain kot..

Masa aku masuk ICU sbb mis abortion, Doc P di ICU ckp CVS skang da tak perlu pakai janin. Kajian terbaru pada awal thn ni, DNA Test boleh pakai darah suami dan isteri. They are not sure about the cost since its been privated but it can be around RM400-500. Doc P guess lah.. So my appointment to discuss about the test was on 7 Sept.. Yeah tgk sebuk2 open house raya tu nk kene g spital plak..

7 Sept. 

i met Doc Ng.. wahh so lucky to get same doc thrice (sepanjang 2 thn di HUKM aku x pernah dpt jupe blk doc yg sama). Before that beselah kene 'tendang sana sini'.. Ikut appointment kene scan dulu, smpi bilik scan, doc in-charge kate x pyh. Naseb baik tak tunggu lama sgt sebelum aku decide utk bekfes dulu.

Jupe doc Ng ms aku bleeding on July. Aku dimasukkan wad utk D&C lps check up dgn Doc P di ICU tp dia as doc in-charge pulak x bg buat.. 'Let's put hope on this. If its meant to be, it will. If not, it will come down naturally'.. He said.

So jupe doc Ng, and he read all the reviews and back to the same answers 'kita tak tahu apa puncanya'.. Aku dah muak dgn semua jawapan tu. Jawapan yg aku dah tahu. 

Aku: So apa lg yang u boleh buat? 

Doc: Kalau puan dpt tahu mengandung, terus cepat2 dtg sini kita akan bg herparin terus. tak perlu tunggu heart filter nmpk.

Aku: Kenapa nk tunggu nek pregnancy? Kenapa my previous pregnancy, u x buat terus?

Doc: Masa ur 4th, u dtg sekali and july coz of bleeding.

DH: Yalah, we went to private since u said u cant do nothing. Bg Duphaston n vitamins saja.

Aku: Yup, we went to private la bcoz my 3rd & 4th pregnancy. U noe or not, as soon as i noe i pregnant i terus dtg sini tp u all tak buat apa2. Keep giving me the same medicine. Now u said wait my 5th to give herparin pulak. (Sedihnya aku Tuhan jer yg tahu.. nak nangis sgt masa ni)

Doc: Ada org smpi 9 kali gugur. Smpi kita tahan di wad utk pantau. 

Aku: How about the DNA test? Doc P said we will hv some briefing abt it today.

Doc tu bleh senyum n start explain kat aku psl CVS tu apa. Tu pun kajian lama. Hm x phm soalan la pulak. Takkan nk suh aku risikokan 5th baby to do the test. Bengong. Bila aku explain apa yg Doc P ckp and insist nk buat, baru dia p checking dgn Prof dia then set appointment aku pada 13 Sept. wohaa~~ Doc Ng ckp kos x tahu sbb darah akan dihantar ke Pusat Darah Negara. Sebelum gerak, Doc Ng sempat pesan 'Puan jgn anxiety sgt, jgn stress, sekarang sudah stress mcm mana mahu mengandung. Buat masa ni relax dulu ok. Smpi sudah boleh menerima.." Ayat Doc terhenti di situ.. Hm muka aku nmpk mcm aku x bleh terima kenyataan ker? Mmg la aku stress kalu dpt Doc ala2 sengal cam td tu.. 

11 Sept.

Doc Ng kol dia mintak butir2 ibubapa kami dan turutan adik beradik. Bila aku cakap belah suami aku x pasti sbb ada abg dan kakak yg telah meninggal dunia. Dia kata pembantu dia akan kol semula.

12 Sept.

Seorang Doc pelatih kol aku nama dia Doc S. Dia minta nama ibu ayah kami dan no ic. Aku terus tya dia kos berkenaan utk aku decide br aku decide nak buat atau tidak. Yelah buatnya harga sampai ribu riban mn nk cekau $$$ tambah2 musim raya ni. So, doc S maklumkan kos ni berharga RM100 jadi aku pn setuju tp dalam hati ada gak terdetik 'Eh, murahnya. Kalau aku gugle, mau dekat USD200' Tp itu kt UK lah..

13 Sept.

Lepas dpt GL, nurse mintak kami copkan borang test tu spt prosedur biasa nk buat BD (blood test). Lepas cop, kaunter terus minta aku g Makmal C 'xpayah byr sbb ada GL' kater die. Haih terpinga2 aku jap.

Odw balik dlm kete baru aku sorekan kemusyikilan aku pd DH.  Dia pun pelik gak. Kenapa murah sgt test ni? Entah2 test biasa jer yg dibuatnya.. Ms odw g kami masing2 bertelagah psl apa yg Dr. Ng terangkan pd kami minggu lepas pasal prosedur ni.

Apa2 pun kami bertawakallah jerlah.. Kalau masih belum temui puncanya, maka kami akan concentrate cara tradisonal dan perubatan Islam pulak..

DNA Test Hari ni!

Pagi tadi jam 5.30 aku dah bgn sumer gara2 DH yg kunci jam awal sbb nk g hospital, takut lambat nnt susah nk parking katernyer. Hadoii dahla mate ni xnak lelap mlm td.. macam2 yg aku pikirkan, macam2 yg bermain di fikiran walaupun aku x pikirkan huhuhu.. Tp sbb aku da janji dgn doc jam 8.30 pg jd xperlulah nk berkejar sgt kan. Sbb da bgn takkan nk tdo balik, so aku pn bersiap dgn sopan santunnya lah lalalala~


Alhamdulillah da setel da amik darah pg td =))). So tunggula 3 bulan lg utk result keluar. DH pun tersengih2 jer tgk kad pesakit die.. "pecah rekod" kate die sbb selama ni mmg die bertahan xnk dptkan rawatan di hospital.. kalau kene tahan wad lg la die xmo huhuuh.. 


Nurse tu suh register bukan apa supaya senang nak labelkan botol darah tu, kang apa2 jd kan payah. Dan masa ni la aku salute sama HRMIS sbb pihak hosp. yg printkan GL utk DH register hari ni.. *thumb ups*


Hari ini klinik G&O x ramai patience. Kalau Hari Rabu tu masyaAllah smpi sesak la klinik x cukup seat. Heran betul yer.. Walau x ramai di klinik G&O ni tp parking mmg punuh gilar bayangkan la kalau Hari Rabu aku kene check up.. Mana x hangin Mr. R pusing 18 kali carik parking hehehe.. Aku mmg saje highlightkan Hari Rabu kat sini sbb klinik kate 'puan register Hari Rabu kan, so smpi bila2 pun appointment puan mesti Hari Rabu'.. Gilesss


I guess maybe this is the last hope we put on BD after this no more blooding2 test.. lobam tgn den asik dicucuk jarum jer ehehe.. Doakan kami temui jawapannya, insyaAllah.

Chrionic Villus Sampling (CVS)

Esok adalah hari yg mendebarkan buat diri aku. Kenapa aku rasa berdebar2? Entahlah aku pn tak tahu tetapi yang yer nyer esok kami akan buat DNA Test menggunakan blood sample kami. Test ni mungkin test yang terakhir aku akan buat di HUKM ni since da dekat 20 blood test yang aku buat semuanya menunjukkan keputusan negatif. Hmmmm kalau tgk kt lengan ni pun masih jelas kesan lobang2 kesan amik darah. Tapi kali ni, aku takkan kesorangan di makmal C tu sbb Mr. R pun kene amik darah gak  ngehngehngeh..


Nama lain bagi DNA Test ni adalah Chrionic Villus Sampling (CVS) di mana kebiasaannya DNA di ambil semasa kandungan berusia 11 - 13 minggu menggunakan jarum suntikan. Uishh mcm negeri jer baca dan ianya boleh menyebabkan risiko keguguran juga. CVS pada dasarnya adalah untuk melihat samada kandungan itu tidak normal seperti Down's Syndrome. Tetapi untuk aku lebih kepada untuk melihat samada darah kami suami isteri sepadan atau ada di antara kami yg membawa gen2 jahat yg menyebabkan kandunganku tidak dtp membesar atau terbantut semasa di awal first trimester.


Tapi oleh kerana teknologi semakin maju, DNA test ni da boleh buat menggunakan darah suami dan isteri juga. So tak perlu risikokan kandungan kan, elok la tu..


Nak tahu lebih lanjut pasal CVS ni bleh baca ni:

What is CVS? 

Chorionic villus sampling (CVS) is a very accurate antenatal test that detects chromosomal abnormalities such as Down's syndrome. It's a diagnostic test, which means that it can tell you with almost complete certainty whether or not your baby has got a particular condition. 

How is the test performed? 

Your obstetrician should give you the opportunity to discuss the pros and cons of the test before you have it. Make a list of all the questions you want to ask; it's easy to forget them when you get to the hospital.

Your bladder needs to be full for the procedure, so you will be asked to drink plenty of water beforehand. You'll be asked to lie down for the test.

Ultrasound is used throughout the procedure, first to confirm how many weeks pregnant you are, and to locate the placenta. The ultrasound examination might be uncomfortable when the doctor presses down on your tummy with a small, hand-held transducer. However, you'll be able to see your baby on the screen which is a bonus!

Depending on your stage of pregnancy, the position of your placenta, or on personal preference, your doctor will choose one of the following methods:

• transvaginal CVS - usually carried out between 11 and 13 weeks of pregnancy, via the cervix. Your doctor will carefully insert fine forceps or a small tube through yourvagina and cervix to reach the placenta.

• transabdominal CVS - usually carried out after 13 weeks, through the abdomen. You may be given a local anaesthetic to numb the wall of your abdomen before a needle is inserted through your abdomen into your uterus to the placenta.

Ultrasound is used continuously to guide insertion of the instrument, whichever method is used. Your doctor will then extract a fragment of chorionic villi, which are tiny finger-like projections on the placenta. The cells taken from the placenta are full of genetic information that can be analysed to reveal the chromosomal make-up and the sex of your baby. If you don't want to know whether you're having a boy or girl, say so.

After the procedure, your baby will be checked using ultrasound. If your blood group is rhesus negative (RhD negative), you'll be offered an injection of anti-D immunoglobin to prevent any problems if your baby's blood is rhesus positive. Find out more in our article on rhesus status.

Will it hurt? 

Many women find the procedure uncomfortable rather than painful, and describe feeling period-type pains. However, it's over relatively quickly. The test lasts no longer than half an hour from start to finish and actually taking the sample is only a matter of a few minutes.

Women who have a transvaginal CVS say it feels rather like having a smear test. Women who have a transabdominal CVS sometimes report a sore tummy afterwards. 

What happens after the test? 

Having a CVS or amniocentesis or any other antenatal test can be physically and emotionally exhausting. Your doctor will advise you to rest after your CVS, if you feel like it. It's a good idea to have someone with you, to drive you home or travel with you if you're using public transport. Spend the rest of the day relaxing if you can, watching TV, reading or dozing.

You might have some cramping in your tummy and a slight loss of blood from thevagina in the first 24 hours after the test. These are nearly always normal side effects, but let your doctor know.

If you notice bleeding or clear fluid leaking from your vagina, or if you have contractions or feel shivery (like you're going down with flu) contact your doctor immediately. 

Why might I choose to have a CVS rather than an amniocentesis? 

The main advantage of CVS over amniocentesis is that it can be performed earlier; usually between 10 and 13 weeks of pregnancy, compared to amniocentesis which is recommended from 15 weeks of pregnancy.

CVS appeals particularly to women who want to know as soon as possible if their baby has a disorder. CVS will be offered to you if:

• a blood test, a nuchal translucency scan or a combination of the two has shown that your baby is at higher risk than usual of having chromosomal problems.

• you are over 35 and haven't had screening for Down's syndrome already.

• you have one or more relatives with a genetic disorder.

• you or your husband is at greater risk of having a child with an inheritable condition, such as thalassaemia.

• you have had a previous pregnancy affected by a genetic abnormality. 

Is CVS more likely than amniocentesis to cause a miscarriage? 

Yes, but only very slightly. About two in every 100 women miscarry as a direct result of CVS compared with about one in every 100 women after amniocentesis. 

Are there any other risks? 

In the past, CVS was associated with babies born with limb defects, but this link was only found when the test was carried out before 10 weeks of pregnancy. It has since been found that such problems are extremely rare and may not be connected to CVS. Nevertheless, CVS is done only after 10 weeks because of the possible risk.

If you have HIV, there is an increased risk of transmission of the virus to your baby during CVS. For this reason, it is best avoided. If you still want to go ahead then you'll need treatment with HAART (highly active antiretroviral therapy) during the procedure to reduce the risk of transmission to your baby.

If you have hepatitis B or hepatitis C, there is no evidence that transmission of the disease to your baby is increased by CVS. 

If the risks of CVS and amniocentesis are about equal, why doesn't everyone have CVS? 

You might not have discovered that you were pregnant until later in pregnancy when an amniocentesis is the usual test offered, or you might have experienced a previous first trimester miscarriage and be unwilling to run that risk again.

Deciding which antenatal test to have (or whether to have any at all) is a very personal decision. You might choose CVS if you have a very specific reason to believe that there might be something wrong with your baby and you want to find out as soon as possible. On the other hand, if your only reason for concern is your age, you might choose to wait for an amniocentesis and minimise the risk of miscarriage.

Will I get the results straight away? 

You might have to wait two to three weeks for the results of the CVS. The sample has to be sent away to a lab to be cultured and the chromosomes fully counted and examined (karyotyped).

A new rapid test has been developed which can give results for some chromosome problems after about three working days. Your doctor will be able to tell you if it is available in your hospital or centre. For more information, visit www.amniopcr.com.

Even if you opt for the rapid test and it comes back clear, the results from the full karyotype may indicate a problem that wasn't checked for as part of the quick test so you'll still have a long wait.

Very occasionally, an abnormality known as mosaicism shows up on the CVS test when it doesn't actually exist in the baby. Mosaicism means that some cells have a chromosomal abnormality while others are normal. If you receive this diagnosis, your doctor will discuss with you whether you would like to have an amniocentesis to confirm the result.

This is probably going to be a very difficult time. It might help to keep busy, and give yourself several treats to help pass the time as easily as possible. 

Sumber: http://www.babycenter.com.my/pregnancy/antenatalhealth/testsandcare/cvs/