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Related Experiment Videos

Chorionic villus sampling: experience with 3016 cases performed by a single operator.

J Williams1, B B Wang, C H Rubin

  • 1Prenatal Diagnostic Center of Southern California, Inc., Beverly Hills.

Obstetrics and Gynecology
|December 1, 1992
PubMed
Summary
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Operator experience significantly improves chorionic villus sampling (CVS) safety and success. Increased experience led to higher diagnostic sample rates and fewer pregnancy losses, highlighting the importance of skilled practitioners in first-trimester genetic testing.

Area of Science:

  • Medical Genetics
  • Obstetrics and Gynecology
  • Reproductive Medicine

Background:

  • First-trimester chorionic villus sampling (CVS) is a crucial diagnostic procedure.
  • Operator skill is hypothesized to influence CVS outcomes.
  • Assessing the impact of cumulative experience is vital for procedural refinement.

Purpose of the Study:

  • To evaluate the safety and efficacy of chorionic villus sampling (CVS).
  • To determine the influence of operator experience on CVS outcomes.
  • To analyze procedural success rates, complications, and pregnancy outcomes in relation to experience.

Main Methods:

  • A retrospective analysis of 3016 transcervical and transabdominal CVS procedures performed by a single operator.
  • Data collection included sampling success rates, complications, cytogenetic results, and pregnancy outcomes.

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  • Analysis focused on the correlation between the number of procedures performed and key outcome metrics.

    • Main Results:

    • A high diagnostic sample success rate of 99.7% was achieved.
    • The mean number of insertions per procedure was 1.1 +/- 0.4.
    • Single insertion success increased from 51% to 96% with operator experience.
    • The overall pregnancy loss rate (1.94%) was comparable to baseline miscarriage risks.
    • Multiple insertions (three or more) were associated with a significantly increased loss rate (6.7% vs. 1.9%).

    Conclusions:

    • Operator experience is a significant determinant of chorionic villus sampling (CVS) safety and efficacy.
    • With increasing experience, the procedure becomes more efficient and safer.
    • Minimizing the number of insertions, particularly avoiding three or more, is crucial for reducing pregnancy loss risk.