Single-center comparison of results of 1000 prenatal diagnoses with chorionic villus sampling and 1000 diagnoses with amniocentesis

Article Abstract:

Prenatal genetic diagnosis is the detection of hereditary disorders before birth. It is commonly done using amniocentesis, the sampling of amniotic fluid surrounding the fetus using a needle that is inserted through the abdomen. Various tests are then performed on the amniotic fluid sample to determine the presence of genetic or biochemical abnormalities in the fetus. Amniocentesis has been performed for over 25 years. Another method of prenatal genetic diagnosis is chorionic villus sampling, which was developed within the past five years. In chorionic villus sampling, a catheter (a tube-like structure) is inserted through the cervix (the opening of the uterus) into the membranes surrounding the fetus. A sample of tissue is taken from the chorionic villi, the projections of tissue containing blood vessels that connect the inner lining of the uterus to the placenta, which provides nutrients to the fetus. Although several different medical centers have confirmed the safety and accuracy of chorionic villus sampling, the experience with chorionic villus sampling at a single medical center has not been previously reported. Therefore, the results of 1,000 chorionic villus sampling procedures were compared with those of 1,000 amniocentesis procedures. All procedures were performed by the same medical personnel, including genetic counselors, laboratory and imaging personnel, and obstetricians. The reasons for prenatal genetic diagnosis, patient characteristics, number of procedures for each patient, number of fetal deaths, laboratory data, and accuracy of technique were assessed. The findings suggest that chorionic villus sampling is as safe and effective as amniocentesis for prenatal genetic diagnosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Amniocentesis, Genetic counseling

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Analysis of fetal loss after transcervical chorionic villus sampling - a review of 719 patients

Article Abstract:

Chorionic villus sampling (CVS), the analysis of fetal tissue obtained from the surrounding layer of the fetus (chorionic membrane) for diagnostic purposes, is performed in the first three months of pregnancy. Ultrasound, use of high frequency sound to visualize internal structures, guides the practitioner in inserting a small instrument (catheter) into the uterus through the opening in the cervix to remove a sample of the membrane. The cells from the tissue sample are then analyzed for genetic defects. Although the risk of the procedure is presumed to be low, it is difficult to determine whether fetal loss when it occurs is due to the procedure or other factors. To determine the factors associated with an increased risk to the fetus, 719 patients undergoing chorionic villus sampling were analyzed. It was found that nine patients lost the fetus four weeks after the procedure, and 19 had losses between 12 weeks after the procedure and the twentieth week of pregnancy. As the number of catheter insert attempts increased, so did the number of fetal losses. The risk of fetal loss was 3 percent after one attempt, 7.8 for two inserts, 14.3 percent for three inserts. The procedure-related fetal loss rate should be included in the counseling of patients.

Complications and side effects, Risk factors, Fetal death

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Comparison of transcervical and transabdominal chorionic villus sampling loss rates in nine thousand cases from a single center

Article Abstract:

Chorionic villus sampling (CVS) performed through the abdominal route may be associated with a lower fetal loss rate than CVS performed through the cervix. CVS is used to obtain cells from the first trimester fetus to allow detection of abnormalities. Researchers compared the fetal loss rates for abdominal and cervical CVS performed at one medical center by three doctors. CVS performed through the cervix caused 125 of 2440 fetuses to die, a rate of 5.12%. A combination of abdominal and cervical CVS produced a drop in the fetal loss rate to 3.07%, with 185 of 6030 fetuses lost. The fetal loss rate started out higher with abdominal CVS, but as the doctors perfected the technique, the loss rate dropped below that of cervical CVS. Both techniques may be used, but their use may vary depending on the patient.

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