What invasive procedure to use in early pregnancy?

Jauniaux, Eric; Pahal, Gurmit S.; Rodeck, Charles H.

doi:10.1053/beog.2000.0102

Cited by 22 publications

(19 citation statements)

References 65 publications

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“…La importancia de que estas indicaciones tengan un valor predictivo alto para encontrar una AC radica en que deben superar el riesgo de pérdida o morbilidad del embarazo secundaria al procedimiento invasivo. Este riesgo varía para amniocentesis entre 0.5% y 1.2%, para biopsia de vellosidad corial entre 2% y 3% y para cordocentesis entre 1% y 2% (18)(19)(20).…”

Section: Discussionunclassified

Valor predictivo positivo del diagnóstico prenatal invasivo para alteraciones cromosómicas

Fandiño-Losada¹,

Lucumí-Villegas²,

Ramírez-Cheyne³

et al. 2018

Rev. Fac. Med.

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Introducción. El diagnóstico prenatal (DP) invasivo para alteraciones cromosómicas (AC) se realiza según las indicaciones de las pruebas no invasivas y se basa en la probabilidad de encontrar un cariotipo alterado.Objetivos. Identificar las indicaciones para la realización de un procedimiento invasivo con el fin de hacer un DP de AC, calcular el valor predictivo positivo (VPP) de cada indicación y estimar la oportunidad relativa (OR) de encontrar una AC.Materiales y métodos. Estudio transversal que caracterizó las indicaciones de procedimientos invasivos para realizar cariotipos en registros de un centro de diagnóstico genético en Cali, Colombia, en el período 2013-2015.Resultados. De 738 registros de cariotipos analizados, 103 (14.0%) tuvieron AC. Las indicaciones más frecuentes fueron alteración anatómica única en ecografía del segundo trimestre (21.4%) y edad materna (18.8%). Las indicaciones con mayor VPP fueron sonolucencia nucal alterada más otro marcador ecográfico (80.0%) y antecedente de 2 o más abortos (30.8%). Las más altas OR de un cariotipo alterado también fueron la sonolucencia nucal más otro marcador ecográfico (OR=1381.6) y el antecedente de 2 o más abortos (OR=153.5).Conclusiones. La ecografía fue la principal herramienta para indicar procedimientos invasivos de DP. Los marcadores bioquímicos integrados fueron una indicación poco frecuente.

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Section: Discussionunclassified

Valor predictivo positivo del diagnóstico prenatal invasivo para alteraciones cromosómicas

Fandiño-Losada¹,

Lucumí-Villegas²,

Ramírez-Cheyne³

et al. 2018

Rev. Fac. Med.

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“…Osnovna metoda prenatalne diagnostike je biopsija horionskih resic (glej poglavje 2.5). Možno jo je narediti med 10. in 14. tednom gestacije (260)(261)(262)(263), vendar se ne priporoča pred 11. tednom gestacije zaradi večjega tveganja za nepravilnosti pri plodu (264). Amniocentezo opravljamo po 16. tednu nosečnosti kadarkoli (253,261,265).…”

Section: Nosečnost In Porodunclassified

“…Možno jo je narediti med 10. in 14. tednom gestacije (260)(261)(262)(263), vendar se ne priporoča pred 11. tednom gestacije zaradi večjega tveganja za nepravilnosti pri plodu (264). Amniocentezo opravljamo po 16. tednu nosečnosti kadarkoli (253,261,265). Iz materiala, ki ga dobimo z biopsijo horionskih resic, ali z amniocentezo lahko zanesljivo ugotovimo spol ploda, hemofilijo in kromosomske nepravilnosti.…”

Section: Nosečnost In Porodunclassified

Nacionalna priporočila za obravnavo bolnikov s hemofilijo

et al. 2017

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The document presents recommendations for the comprehensive treatment of patients with haemophilia in Slovenia. It enables health workers at all three levels of health care to become well-acquainted with all the possible aspects of treatment based on the best practices of major centres worldwide, and on the studies and experience of health professionals at the National Haemophilia Centre, University Medical Center Ljubljana. The document contains definitions, treatment algorithms and lists of medications with their characteristics and appropriate dosages. It specifically defines indications for the exclusive competence of the tertiary level in Ljubljana due to the actual availability of teams and laboratory options. It also contains an extensive list of the literature on haemophilia.

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“…Interestingly, in early studies the rate of fetal loss was not associated with microbial colonization of the instruments used (4,24,26). However, the incidence of intrauterine infection after CVS declined to Ͻ0.1% since the use of a single catheter was abandoned when multiple insertions to obtain placental tissue are required (14). Still, Silverman et al reported a transient bacteremia in 1.8% of women undergoing CVS, finding no significant difference between the transcervical and transabdominal approaches (25).…”

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confidence: 99%

“…An active vaginal infection is a contraindication for an invasive transcervical procedure (14), though the need for routine cultures before CVS has so far been declined by the studies of Kagie et al (15) and Wilson et al (30).…”

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confidence: 99%

First Report of Atopobium vaginae Bacteremia with Fetal Loss after Chorionic Villus Sampling

et al. 2011

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Infectious complications after chorionic villus sampling (CVS) are rare (<0.1%) but can lead to maternal sepsis and spontaneous abortion. We report the first bacteremia with Atopobium vaginae and suggest A. vaginae to be a pathogenic microorganism that can lead to intrauterine infection and fetal death following CVS. CASE REPORTA 40-year-old woman, gravida 7, para 3, underwent transcervical chorionic villus sampling (CVS) in the 12th week of pregnancy for advanced maternal age. Her obstetric history revealed three healthy children, one spontaneous miscarriage, one induced abortion, and an ectopic pregnancy with tubal removal. Her medical history revealed a mild diaphragmatic hernia for which she used acid secretion inhibitors. The CVS was done under ultrasound guidance using a biopsy forceps. In a single attempt, 30 mg of villi were obtained without complications.In the days following the CVS procedure, the patient developed fever with temperature up to 40°C and vomiting. Seven days after the CVS, she visited the emergency room for ongoing fever and chills; there was no abdominal pain or vaginal blood loss. Laboratory results were as follows: Hb, 10.8 g/dl; white blood count, 2.5 ϫ 10 9 /liter (89.6% neutrophils); C-reactive protein, 222 mg/liter. On X-ray and abdominal ultrasound no signs of pneumonia or abdominal focus were found and a normal fetal heartbeat was observed. The patient was admitted. A blood culture (including two bottles, for aerobic and anaerobic incubation, respectively) and a cervix sample were taken, after which antibiotic treatment was initiated with intravenous cefuroxime (750 mg, three times a day [t.i.d.]). Three days later, the patient developed cramping abdominal pain and had blood-stained vaginal discharge. By ultrasonography, fetal death was observed. The abortion started spontaneously but had to be completed by aspiration curettage. Following the procedure, the temperature normalized and cefuroxime therapy was ended (day 4). The patient was discharged from the hospital at day 5 after admission. At the day of discharge, the anaerobic blood culture bottle became positive with Atopobium vaginae (see below), after which amoxicillin (1 g, four times a day [q.i.d.]) was prescribed for 2 weeks.Microbiological data. No cultures of the cervix or vagina were done before the CVS procedure since the patient had no symptoms of vaginitis or bacterial vaginosis.At hospital admission, a sample of the cervix and one set of blood cultures were taken before antibiotics were initiated. A urinary culture and three more blood cultures were taken in the next 14 h. Microscopic examination and culture of the urinary sample were not indicative for an infection. The culture of the cervix smear yielded no Neisseria gonorrhoeae, no group B beta-hemolytic streptococci, and no yeasts. However, a culture of small grayish nonhemolytic colonies grew on the blood plate in an anaerobic environment. Gram staining showed Gram-positive rod-shaped organisms which were considered a nonpathogenic component of the vaginal fl...

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What invasive procedure to use in early pregnancy?

Cited by 22 publications

References 65 publications

Valor predictivo positivo del diagnóstico prenatal invasivo para alteraciones cromosómicas

Valor predictivo positivo del diagnóstico prenatal invasivo para alteraciones cromosómicas

Nacionalna priporočila za obravnavo bolnikov s hemofilijo

First Report of Atopobium vaginae Bacteremia with Fetal Loss after Chorionic Villus Sampling

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