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Techniques of chorion villus sampling.

R H Ward

    Bailliere'S Clinical Obstetrics and Gynaecology
    |September 1, 1987
    PubMed
    Summary

    Chorionic villus sampling (CVS) offers an alternative to amniocentesis but carries a higher risk. Transabdominal aspiration may reduce infection risk and allow earlier diagnosis compared to transcervical methods.

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    Area of Science:

    • Obstetrics and Gynecology
    • Prenatal Diagnosis
    • Medical Procedures

    Background:

    • Chorionic villus sampling (CVS) is increasingly offered as a prenatal diagnostic alternative to amniocentesis.
    • While randomized safety studies are ongoing, CVS is available in many diagnostic centers.
    • Counseling involves informing patients about a pregnancy risk of 2-4%, which is higher than amniocentesis.

    Purpose of the Study:

    • To review the safety and efficacy of different chorionic villus sampling (CVS) techniques.
    • To compare transcervical and transabdominal approaches for CVS.
    • To evaluate fetal loss and failure rates associated with various CVS methods.

    Main Methods:

    • Review of transcervical CVS methods including aspiration (Portex cannula) and biopsy (rigid forceps).
    • Examination of transabdominal aspiration as an alternative approach.
    • Analysis of data from centers with extensive experience in CVS procedures.

    Main Results:

    • Transcervical aspiration (Portex cannula) in over 5000 cases showed a failure rate <1% and fetal loss of 2.2% (up to 4-7% with full follow-up).
    • Transcervical biopsy with rigid forceps has comparable failure and fetal loss rates.
    • Transabdominal aspiration demonstrates potential for reduced infection risk and earlier diagnosis (12-14 weeks vs. 16 weeks for amniocentesis), with fetal losses of 1.8-3.2% and failure rates of 1.9-4.2%.

    Conclusions:

    • Chorionic villus sampling (CVS) is an evolving technique with varying risks and benefits depending on the method used.
    • Transabdominal aspiration presents a promising alternative, potentially minimizing infection and allowing earlier diagnosis.
    • Further investigation is needed before routine adoption of CVS as a standard alternative to amniocentesis.

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