Procedure‐related risk of miscarriage following chorionic villus sampling and amniocentesis

Beta, J.; Zhang, Wei; Geris, Samar; Kostiv, V.; Akolekar, Ranjit

doi:10.1002/uog.20293

Cited by 40 publications

(40 citation statements)

References 15 publications

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“…Our historical cohort study suggests that the rates of fetal loss after genetic amniocentesis are generally low, but they are significantly higher among twins that singletons. In previous studies, the reported rates of fetal losses ranged from 0.8% to 1.56% for singleton pregnancies, 5,6,12‐15 and 1.2% to 3.2% for twin pregnancies 3,16,17 . The possible reasons for these differences may be several.…”

Section: Discussionmentioning

confidence: 94%

Comparison of spontaneous fetal loss rates between women with singleton and twin pregnancies after mid‐trimester amniocentesis ‐ A historical cohort study

et al. 2020

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Objective To assess and compare fetal loss rates before 28 weeks of singleton and twin pregnancies after mid‐trimester amniocentesis. Method This historic cohort study included 13 773 women with singletons and 426 women with twins undergoing mid‐trimester amniocentesis from 1/2015 to 3/2017. Pregnancies resulting in termination or selective reduction before 28 weeks were excluded, as well as twin gestations undergoing single‐puncture amniocentesis. Fetal loss rates were compared between singleton and twins taking into account maternal characteristics, amniocentesis procedure, and fetal chromosomal abnormalities. Results The rates of fetal chromosomal abnormalities were similar in singleton and twin gestations (1.13% vs 0.70%, P = .253). No difference was found in maternal or fetal characteristics, or amniocentesis procedure between the two groups. The fetal loss rate was significantly higher in twin compared with singleton pregnancies (1.91% vs 0.24%, P < .001, RR = 8.25 [95% CI: 4.51 to 15.09]). The fetal loss rate between monochorionic twins and dichorionic twins was similar (1.80% vs 1.78%, P = 1.000). Conclusions Twin pregnancies have higher risk of fetal loss after mid‐trimester amniocentesis, which cannot be explained by differences in rates of fetal chromosomal abnormalities, maternal characteristic, or amniocentesis technique.

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Section: Discussionmentioning

confidence: 94%

Comparison of spontaneous fetal loss rates between women with singleton and twin pregnancies after mid‐trimester amniocentesis ‐ A historical cohort study

et al. 2020

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“…The electronic search yielded 2943 potentially eligible citations, of which 2911 were excluded because they were a duplicate, case report or letter or they did not meet the inclusion criteria following review of the title or abstract, leaving 32 studies for full-text review. After the full-manuscript review, we finally considered 12 studies for amniocentesis 6,7,[9][10][11][19][20][21][22][23][24][25] and eight studies for CVS [6][7][8]10,11,[26][27][28] (four studies 6,7,10,11 reported on both procedures). Of those, one study 26 was eventually excluded, as it reported cumulative data for miscarriage and stillbirth, leaving 12 studies for amniocentesis and seven for CVS ( Figure 1).…”

Section: Data Search Resultsmentioning

confidence: 99%

“…Overall (I 2 = 70.1%; P < 0.0001) Corrado (2012) 25 Beta (2019) 11 Odibo (2008) 23 Muller (2002) 19 Bakker (2017) 7 Wulff (2016) 6 Kong (2006) 21 Theodora (2015) 9 Malan (2018) 10 Towner (2007) 22 Eddleman (2006) Malan (2018) 10 Akolekar (2011) 27 Wah (2017) 8 Beta (2019) 11 Odibo (2008) 28 Bakker (2017) for chromosomal abnormalities ( Table 1). The pooled risk RD (i.e.…”

Section: Favors Amniocentesis Favors Controlmentioning

confidence: 99%

“…When studies with similar risk levels between the amniocentesis and control groups were analyzed, there was no significant procedure-related risk (pooled RD, 0.12% (95% CI, −0.05 to 0.30%; I 2 = 44.1%)) following amniocentesis (Figure 3a). The procedure-related risk following CVS was non-significant when studies with similar level of risk 20 Malan (2018) 10 Wulff (2016) 6 Theodora (2015) 9 Muller (2002) 19 Beta (2019) 11 Subtotal (I 2 = 38.1%; P = 0.152) Kong (2006) 21 Towner (2007) 22 Bakker (2017) 7 Pitukkijronnakorn (2011) Subtotal (I 2 = 0.0%; P = 0.743) Subtotal (I 2 = 0.0%; P = 0.605) Wulff (2016) 6 Beta (2019) 11 Akolekar (2011) 27 Odibo (2008) 28 Wah (2017) between the CVS and the control groups were compared (pooled RD, −0.11% (95% CI, −0.29 to 0.08%); I 2 = 0%). In contrast, CVS was associated with a pooled procedure-related risk of 0.48% (95% CI, 0.17-0.78; I 2 = 0%) when studies with dissimilar level of risk between the intervention and control groups were analyzed (Figure 3b).…”

Section: Favors Amniocentesis Favors Controlmentioning

confidence: 99%

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Risk of miscarriage following amniocentesis or chorionic villus sampling: systematic review of literature and updated meta‐analysis

Salomon

Sotiriadis

Wulff

et al. 2019

Ultrasound in Obstet & Gyne

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258

168

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Objective To estimate the procedure‐related risk of miscarriage after amniocentesis and chorionic villus sampling (CVS) based on a systematic review of the literature and an updated meta‐analysis. Methods A search of MEDLINE, EMBASE and The Cochrane Library was carried out to identify studies reporting complications following CVS or amniocentesis. Eligible for inclusion were large controlled studies reporting data for pregnancy loss prior to 24 weeks' gestation. Study authors were contacted when required to identify additional necessary data. Data for cases that had an invasive procedure and controls were inputted into contingency tables and the risk of miscarriage was estimated for each study. Summary statistics based on a random‐effects model were calculated after taking into account the weighting for each study included in the systematic review. Procedure‐related risk of miscarriage was estimated as a weighted risk difference from the summary statistics for cases and controls. Subgroup analyses were performed according to the similarity in risk levels for chromosomal abnormality between the invasive‐testing and control groups. Heterogeneity was assessed using the I2 statistic. Egger's bias was estimated to assess reporting bias in published studies. Results The electronic search yielded 2943 potential citations, from which 12 controlled studies for amniocentesis and seven for CVS were selected for inclusion in the systematic review. A total of 580 miscarriages occurred following 63 723 amniocentesis procedures, resulting in a weighted risk of pregnancy loss of 0.91% (95% CI, 0.73–1.09%). In the control group, there were 1726 miscarriages in 330 469 pregnancies with a loss rate of 0.58% (95% CI, 0.47–0.70%). The weighted procedure‐related risk of miscarriage following amniocentesis was 0.30% (95% CI, 0.11–0.49%; I2 = 70.1%). A total of 163 miscarriages occurred following 13 011 CVS procedures, resulting in a risk of pregnancy loss of 1.39% (95% CI, 0.76–2.02%). In the control group, there were 1946 miscarriages in 232 680 pregnancies with a loss rate of 1.23% (95% CI, 0.86–1.59%). The weighted procedure‐related risk of miscarriage following CVS was 0.20% (95% CI, −0.13 to 0.52%; I2 = 52.7%). However, when studies including only women with similar risk profiles for chromosomal abnormality in the intervention and control groups were considered, the procedure‐related risk for amniocentesis was 0.12% (95% CI, −0.05 to 0.30%; I2 = 44.1%) and for CVS it was −0.11% (95% CI, −0.29 to 0.08%; I2 = 0%). Conclusions The procedure‐related risks of miscarriage following amniocentesis and CVS are lower than currently quoted to women. The risk appears to be negligible when these interventions were compared to control groups of the same risk profile. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

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“…On the other hand, CVS results have higher diagnostic uncertainty because of placental mosaicism and the procedure-related complication rate is higher compared to second trimester amniocentesis (American College of Obstetricians and Gynecologists, 2007;Wapner, 1997). Nevertheless, some recent literature demonstrated similar procedure-related pregnancy loss rates for CVS and amniocentesis (Beta, Zhang, Geris, Kostiv, & Akolekar, 2019).…”

Section: Introductionmentioning

confidence: 89%

Chorionic villus sampling experience of a reference perinatal medicine center

Beksaç

Ünal

Fadıloğlu

et al. 2019

Annals of Human Genetics

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Aim To share the chorionic villus sampling (CVS) experience of a single surgeon in our institution. Methods This retrospective study consists of CVS cases performed between 2000 and 2018. A total of 66 types of indications were classified under two main categories, the screening group (SG) and the inherited disease group (IDG). The SG and IDG were compared in terms of clinical characteristics of the patients, Beksaç obstetrics index (BOI), timing of CVS in terms of gestational week, and complications and termination of pregnancy (TOP) rate. Results CVS was performed at 656 women, 69 and 587 of whom were included in the SG and IDG, respectively. CVS indications of the SG were determined as advanced maternal age, high risk in combined test, fetal anomaly suspicion in ultrasonography, and increased nuchal translucency in 23, 23, 14 and 9 cases, respectively. On the other hand, CVS indications of the IDG were hereditary disorders related to hematological, muscular, and metabolic systems for 233, 179, and 116 cases, respectively. Furthermore, 32 patients had a single‐gene disorder and 14 had a neurodegenerative disease. According to the results of CVS, 359 fetuses were found to be normal (54.73%), while 205 (31.25%) and 92 (14.02%) fetuses were found to be disorder‐positive or carriers, respectively. Two hundred pregnant women accepted TOP. Eight (1.2%) pregnancies ended with abortion after CVS. Statistically significant differences were observed in BOI and TOP rate between SG and IDG (p: 0.042 and 0.013). Conclusion Hereditary disorders were the most common CVS indications and the acceptance of TOP was significantly higher in this group.

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Procedure‐related risk of miscarriage following chorionic villus sampling and amniocentesis

Cited by 40 publications

References 15 publications

Comparison of spontaneous fetal loss rates between women with singleton and twin pregnancies after mid‐trimester amniocentesis ‐ A historical cohort study

Comparison of spontaneous fetal loss rates between women with singleton and twin pregnancies after mid‐trimester amniocentesis ‐ A historical cohort study

Risk of miscarriage following amniocentesis or chorionic villus sampling: systematic review of literature and updated meta‐analysis

Chorionic villus sampling experience of a reference perinatal medicine center

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