Pregnancy outcome after transcervical cvs with a flexible biopsy forceps: Evaluation of risk factors

Abstract

The pregnancy outcome of 1936 women who had transcervical chorionic villus sampling (CVS) with a flexible biopsy forceps was evaluated. Follow-up until 4 weeks after delivery was 99.4 per cent. Various patient- and procedure-related risk factors for spontaneous loss (fetal or neonatal death) were analysed using stepwise logistic regression analysis. The overall spontaneous loss rate was 4.5 per cent. Factors found to be significantly associated with spontaneous loss were quantity of villi < or = 15 mg (relative risk (RR) 2.13), a history of first-trimester miscarriage (RR 1.87) or delivery between 16 and 27 weeks (RR 3.87), cervical culture positive for anaerobes (RR 4.52) or group B streptococcus (RR 3.62), post-procedural bleeding > 3 days (RR 1.99), and multiple insertions (RR 2.64). Significant differences in loss rates between individual operators were found. A learning effect was not present. There were no infants born with terminal transversal limb anomalies in our series. We conclude that knowledge about significant risk factors for spontaneous loss after CVS is important both for obstetricians carrying out CVS procedures and for women seeking prenatal diagnosis.

First 10 000 chorionic villus samplings performed on singleton pregnancies by a single operator

“…Clinicians can thus take advantage of the developments in recombinant DNA technology, broadening the range of gene defects that can be detected prenatally. Most large reports on CVS either represent collaborative efforts or are from centres in which at least two or more operators of different technical levels have contributed to the clinical experience (Canadian Collaborative CVS-Amniocentesis Clinical Trial Group, 1989;Jahoda et al, 1989;Rhoads et al, 1989;Hallak et al, 1992;Jackson et al, 1992; MRC Working Party on the Evaluation of Chorionic Villus Sampling, 1991;Smidt-Jensen et al, 1992;Williams et al, 1992;Ammala et al, 1993;Jackson and Wapner, 1993;Palo et al, 1994;Lunshof et al, 1995). Details of a large experience by a single operator should further delineate the potential of CVS.…”

Enrichment, identification and analysis of fetal cells from maternal blood: evaluation of a prenatal diagnosis system

“…Transcervical CVS was performed, between 10 and 13 weeks of gestation, by a small biopsy forceps (Lunshof et al, 1995). Immediately after the procedure, 20 ml of peripheral blood were drawn and collected in EDTA tubes.…”

Genetic analysis of fetal nucleated red blood cells from CVS washings

“…In this study 20 transcervically obtained samples of normal male fetuses were examined. All biopsies were taken by a¯exible biopsy forceps (Lunshof et al, 1995) with a mean biopsy size of 32 mg (range 10±80 mg).…”