First-trimester transcervical chorionic villus sampling by biopsy forceps versus mid-trimester amniocentesis: a randomized controlled trial project

Abstract

Up to now, no data are available comparing amniocentesis and chorionic villus sampling (CVS) using biopsy forceps. A series of 1313 consecutive women referred to our unit before 12 weeks of pregnancy for fetal cytogenetic analysis because of advanced maternal age, were randomized into CVS with the use of transcervical biopsy forceps or mid-trimester amniocentesis. The diagnostic success rates of the two groups were 98 per cent and 100 per cent, and a second procedure was needed in 4.1 per cent (13/314) and in 0. 3 per cent (1/358), respectively. Follow-up was achieved in 98.7 per cent of the pregnancies. Postprocedure spontaneous fetal losses, until the first week after birth, in the 672 pregnancies that completed the trial accounted for 2.2 per cent (7/314) in the CVS group and 2.8 per cent (10/358) in the amniocentesis group. Although the trial was prematurely discontinued, and therefore the sample size was smaller than initially planned, the results indicate that transcervical CVS was as safe as mid-trimester amniocentesis.

Amniocentesis and chorionic villus sampling for prenatal diagnosis

“…The Denmark 1992 trial was designed as a three-way randomisation of women classified as low genetic risk (transabdominal CVS versus transcervical CVS versus amniocentesis). Borrell 1999 randomised women to transcervical CVS (9 to 13 weeks) or amniocentesis (15 to 18 weeks). This trial was stopped prematurely when second trimester biochemistry screening was introduced.…”

“…Randomisation was organised by telephone in all four trials (Borrell 1999; Canada 1992; Denmark 1992; MRC 1991), apart from the Finnish arm of the MRC trial (MRC (Finland) 1993), where sequentially numbered sealed envelopes were used. The outcome of pregnancy is reported for all women in the Canada 1992 trial, 99% of women in the MRC 1991 trial, and 93% in the Denmark 1992 trial.…”

“…There was a significant dropout rate in Borrell 1999 (33.5%) due to pre-procedure miscarriages and failure to attend allocated procedure. Also, 43 women in the CVS group and seven women in the amniocentesis groups changed the allocated procedure and were excluded from the final analysis.…”

Amniocentesis and chorionic villus sampling for prenatal diagnosis

“…Four trials compared transcervical CVS with second trimester amniocentesis (Borrell 1999;Canada 1992;Denmark 1992;MRC (Finland) 1993). Total pregnancy loss was higher after transcervical CVS (RR 1.40; 95% CI 1.09 to 1.81), but this results has to be interpreted cautiously.…”

Fetal mesenchymal stem cells: isolation, properties and potential use in perinatology and regenerative medicine

“…[8][9][10][11][12][13][14][15][16][17][18] Cells from amniotic fluid and chorionic villi are still key for antenatal diagnosis. [19][20][21][22] The principal SC type isolated from these sources is mesenchymal as they show cell surface markers and morphology that are common with mesenchymal cells from other sources. 8,14,[16][17][18] They have an expansion potential that is superior than that for adult tissue-derived SCs and are less immunogenic as they do not express human leucocyte antigen (HLA) type 2 surface antigens.…”