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First 10,000 chorionic villus samplings performed on singleton pregnancies by a single operator
B Brambati1, L Tului, C Cislaghi
1L. Mangiagalli Institute, First Clinic of Obstetrics and Gynaecology, University of Milan, and Reproductive Medicine Centre, Italy.
Prenatal Diagnosis
|April 29, 1998
Summary
Chorionic villus sampling (CVS) is a safe and effective prenatal diagnostic test. This study of 10,000 pregnancies shows high success rates and accuracy for chromosomal and DNA investigations, with low fetal loss rates.
Area of Science:
- Prenatal Diagnostics
- Medical Genetics
- Obstetrics
Background:
- Chorionic villus sampling (CVS) is a crucial first-trimester prenatal diagnostic procedure.
- Large-scale studies are essential to evaluate the safety and efficacy of CVS techniques.
Purpose of the Study:
- To assess the outcomes of 10,000 chorionic villus sampling (CVS) procedures.
- To compare transabdominal (TA) and transcervical (TC) CVS methods.
- To evaluate diagnostic accuracy and fetal loss rates.
Main Methods:
- 10,000 singleton pregnancies underwent CVS between 8 and 32 weeks gestation.
- Procedures included transabdominal (TA) and transcervical (TC) approaches.
- Indications included chromosomal risk, Mendelian disorders, and DNA investigations.
Main Results:
- High sampling success rates: 99.8% for TA and 99.2% for TC by second insertion.
- TA sampling showed higher first-insertion success (98%) and fewer small samples.
- Cytogenetic analysis accuracy was 99.4%; 1.30% mosaicism/rare trisomies. Five DNA diagnostic errors (0.51%) occurred.
- Fetal loss rate was 2.58%, increasing with maternal age. No significant increase in malformations compared to national data.
Conclusions:
- CVS is a highly successful and accurate prenatal diagnostic tool.
- Transabdominal CVS may offer advantages in first-insertion success and sample size.
- The procedure's safety profile is favorable, with fetal loss rates comparable to national standards and increasing with maternal age.