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Related Experiment Videos

Factors associated with multiple-pass procedures during chorionic villus sampling: a video analysis.

R K Silver1, S N MacGregor, E D Hobart

  • 1Division of Maternal-Fetal Medicine, Evanston Hospital, IL 60201.

Prenatal Diagnosis
|March 1, 1992
PubMed
Summary

Multiple placental passes during chorionic villus sampling (CVS) increase fetal loss risk. Optimizing needle placement within the central placental mass can reduce repeat aspirations, enhancing procedural success and safety.

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Area of Science:

  • Obstetrics and Gynecology
  • Fetal Medicine
  • Minimally Invasive Procedures

Background:

  • Multiple placental passes during chorionic villus sampling (CVS) are associated with an increased risk of fetal loss.
  • Factors contributing to repeat aspiration attempts in CVS are not well understood.

Purpose of the Study:

  • To identify anatomical and technical variables linked to multiple-pass procedures during CVS.
  • To evaluate the impact of these variables on sampling efficacy.

Main Methods:

  • A retrospective review of 205 videotaped CVS procedures, categorized as single-pass (163) or multiple-pass (42).
  • Procedures were analyzed blinded to pregnancy outcome, assessing route, placental location, uterine position, and needle/catheter placement.
  • A case-control cohort was used to evaluate technical variables independently.

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Main Results:

  • Neither sampling route nor placental location alone predicted multiple passes.
  • A posterior placenta combined with uterine retroversion was more frequent in multiple-pass cases.
  • Suboptimal needle placement (transabdominal) and limited catheter tip penetration (transcervical) characterized multiple-pass procedures.

Conclusions:

  • Consistent placement of the sampling device tip within the central placental mass is crucial for maximizing single-pass success rates in CVS.
  • Emphasizing this technical nuance can help reduce the frequency of multiple-pass procedures and associated risks.