Chorionic villi sampling: Clinical experience, immediate complications, and patient attitudes

Perry, Tracy B.; Vekemans, Michel; Lippman, Abby; Hamilton, Emily; Fournier, P.

doi:10.1016/0002-9378(85)90002-x

Cited by 33 publications

(14 citation statements)

References 15 publications

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“…Premarital screening has been recently made compulsory in Lebanon; however, there are currently no data concerning the effects of genetic counselling and acceptance of prenatal diagnosis in countries such as Lebanon. In fact, most studies have been conducted in North America and Europe and show high levels of uptake of prenatal diagnostic procedures (Modell et al, 1984;Lippman et al, 1985;Perry et al, 1985;McGovern et al, 1986;Cao et al, 1987;Cox, 1987, 1988), but this might not be the case in Middle-Eastern societies, because of different cultural and religious beliefs. Lebanon is a mosaic of different religious communities, of various educational and socioeconomic backgrounds.…”

Section: Introductionmentioning

confidence: 99%

Acceptance of First-Trimester Prenatal Diagnosis for the Haemoglobinopathies in Lebanon

Zahed

Bou-Dames²

1997

Prenat. Diagn.

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We have interviewed 83 couples at risk for a haemoglobin disorder, mostly β‐thalassaemia, in an effort to evaluate their attitude towards first‐trimester prenatal diagnosis. Most of the families had received poor education and were of low socio‐economic status and more than half of the couples were not properly aware of their genetic risk. Fifty‐nine per cent of the couples were definitely in favour of prenatal diagnosis, 23 per cent were uncertain at the time of the interview, and 18 per cent were opposed to such testing, because of their religious conviction against termination of a pregnancy. Another important factor which seems to influence choice was the cost of the test. Essential issues that arise from this study include the importance of a control programme adapted to particular populations, proper information and counselling, and the need for financial support in countries such as Lebanon. © 1997 John Wiley & Sons, Ltd.

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Section: Introductionmentioning

confidence: 99%

Acceptance of First-Trimester Prenatal Diagnosis for the Haemoglobinopathies in Lebanon

Zahed

Bou-Dames²

1997

Prenat. Diagn.

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“…Studies carried out before the risk and accuracy of CVS had been established showed that women were almost equally divided as to their preferences for amnio or for CVS Perry et al, 1985;McGovern et al, 19861. Those preferring CVS usually chose this technique because it allows testing at an earlier gestational age, a shorter wait for results, and a first trimester termination.…”

Section: Cvs and Amniocentesismentioning

confidence: 99%

“…Those preferring CVS usually chose this technique because it allows testing at an earlier gestational age, a shorter wait for results, and a first trimester termination. By contrast, women preferring amnio did so largely because of its known low risk of causing a spontaneous abortion Perry et al, 1985;McGovern et al, 19861. Not surprisingly, physician preferences and the reasons for them, also measured before investigations of CVS were completed, paralleled those of the women studied previously . Furthermore, as a group, physicians who preferred amnio overall appeared more "conservative".…”

Section: Cvs and Amniocentesismentioning

confidence: 99%

“…Such studies demonstrated the need for a randomized clinical trial to determine miscarriage rates attributable to the procedure and to further establish accuracy and reliability before CVS was offered to the public [Lippman, 1984;Lippman et al, 1984Lippman et al, , 1985Perry et al, 1985). Randomized clinical trials allow one to evaluate without bias the true efficacy of a new medical procedure [Hill, 19821 since they: 1) eliminate selection bias on the part of both the participant and the investigator; 2) tend to create groups that are comparable in al1 factors, whether known or unknown; and 3) give validity to the statistical treatment of data [Fischer, 1966;Byar et al, 1976;Mausner and Kramer, 19851. In 1984, investigators at McGill began a randomized clinical trial (RCT) of CVS [Perry et al, 19851.…”

Section: Introductionmentioning

confidence: 99%

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Prenatal diagnosis and the Canadian collaborative randomized trial of chorionic villi sampling: The physician's view

Fahy

Lippman

Opitz³

et al. 1988

Am. J. Med. Genet.

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Women eligible for the Canadian randomized trial of chorionic villi sampling (CVS) often cite physician influence as a reason for refusing to participate. To measure directly physicians' attitudes to and knowledge of prenatal diagnosis (PND), amniocentesis, CVS, randomized trials, and the Canadian trial, a 3-page questionnaire was mailed to all registered obstetricians in British Columbia (BC) and in Montreal (Mtl). The overall response rate was 70%. Most physicians thought PND was important and that it was their role to discuss and advise PND to their patients. Physicians were split in their preferences for amniocentesis or CVS (32% vs. 34%); reasons for their preferences paralleled those given by women studied previously by us. Physicians who thought CVS was too experimental, who were hesitant about the trial or who were less likely to discuss the study with patients were older, less likely to have participated in a randomized trial previously and less comfortable with randomization and discussing uncertain risks with patients. Mtl physicians were less aware and more hesitant about the Canadian trial than those in BC. Moreover, Mtl physicians were more likely to consider the ongoing trial inappropriate and too experimental than BC physicians. Because physicians act as "gatekeepers," educating them about new technologies and about randomized studies is essential for ensuring both participant's access to a new procedure and success of the randomized trial.

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“…If an abortion is indicated, we observed that maternal mor bidity in the 2nd trimester is increased. With chorionic villus sampling (CVS) the karyo type is known already in the 1st trimester, which is a major medical and psychological benefit [1,2]. This, however, has to be weighed against a higher risk of abortion.…”

Section: Introductionmentioning

confidence: 99%

Abortion Risk in Chorionic Villus Sampling

Flores-Genger

Husslein²,

Knogler³

et al. 1988

Gynecol Obstet Invest

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100 patients were examined to evaluate the risk of abortion of chorionic villus sampling. In the 8th-10th week of pregnancy a catheter with a mandrin was introduced into the chorion frondosum under ultrasound guidance. The mandrin was then removed and trophoblast tissue obtained by aspiration. The patients agreed to postpone elective termination of pregnancy for 2 weeks. Another ultrasound was performed before suction curettage. With increasing experience, the abortion rate dropped to 4%, whereas the rate of successful biopsies and analyses rose to more than 90%. Based on these results, chorionic villi sampling was made available at the 1 st Department of Obstetrics and Gynecology, University of Vienna, as an alternative method to amniocentesis. Out of 38 biopsies, 25 karyotypes were normal, two biopsies revealed pathological results (trisomy 21 22), 11 samples showed no results (insufficient tissue or no mitoses). One patient had a spontaneous abortion (trisomy 22) and one an abortion due to infection. Chorionic villus sampling could replace amniocentesis because chromosomal anomalies may be detected already in the 1 st trimester of pregnancy.

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Chorionic villi sampling: Clinical experience, immediate complications, and patient attitudes

Cited by 33 publications

References 15 publications

Acceptance of First-Trimester Prenatal Diagnosis for the Haemoglobinopathies in Lebanon

Acceptance of First-Trimester Prenatal Diagnosis for the Haemoglobinopathies in Lebanon

Prenatal diagnosis and the Canadian collaborative randomized trial of chorionic villi sampling: The physician's view

Abortion Risk in Chorionic Villus Sampling

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