Randomized comparison of amniocentesis and transabdominal and transcervical chorionic villus sampling

Evaluating the Rate and Risk Factors for Fetal Loss After Chorionic Villus Sampling

“…The loss rate in the CVS group was 2.7%. 6,14,17,18,20 Although agreeing with previous suggestions that the transcervical procedures may be technically more difficult, one advantage of this method is the ability to obtain more villi with a single pass and generally a painless procedure for the patient. This rate is within the range previously reported in other studies.…”

“…4 -16 The definition of fetal loss has varied from losses within 2 weeks of the procedure, less than 24 weeks, less than 28 weeks, or term. 6,9,17,18 These trials did not have a comparison group that had no invasive procedure to provide estimates of the procedure-related loss rates. 6,9,17,18 These trials did not have a comparison group that had no invasive procedure to provide estimates of the procedure-related loss rates.…”

Intra-Uterine Fetal DemiseCaused by Amniotic Band Syndromeafter Standard Amniocentesis

“…Kino [17] and Poswillo [18] have demonstrated in animal models that strangulation furrows, limb reduction defects and cleft lip or palate can be late sequels of invasive prenatal procedures. On the other hand, Jackson et al [19] and SmidtJensen et al [20] could not demonstrate an increased risk after amniocentesis in humans. Nevertheless, strangulation with torsion of the umbilical vessels by an amniotic band may be a rare fatal complication of a routine prenatal karyotyping.…”

ISUOG Practice Guidelines: invasive procedures for prenatal diagnosis

“…The fetal loss rate after transcervical CVS was reported to be 2.5% in a retrospective series of 1251 procedures, and very similar miscarriage rates (2.5% vs 2.3%) were reported in a large RCT comparing transcervical with transabdominal CVS ( EVIDENCE LEVEL: 1+ ). One randomized study compared transabdominal CVS with second‐trimester amniocentesis and found no significant difference in the total pregnancy loss between the two procedures (6.3% vs 7%; relative risk (RR), 0.90 (95% CI, 0.66–1.23)) ( EVIDENCE LEVEL: 1– ). However, a meta‐analysis of four randomized trials showed that, compared with second‐trimester amniocentesis, transcervical CVS carries a significantly higher risk of total pregnancy loss (RR, 1.40 (95% CI, 1.09–1.81)) and spontaneous miscarriage (RR, 1.50 (95% CI, 1.07–2.11)).…”