Second‐trimester amniocentesis vs. chorionic villus sampling for prenatal diagnosis in multiple gestations

Antsaklis, Aris; Souka, Athena P.; Daskalakis, G.; Kavalakis, Y.; Michalas, Stylianos

doi:10.1046/j.1469-0705.2002.00826.x

Cited by 56 publications

(47 citation statements)

References 41 publications

(23 reference statements)

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“…9,10 Practice has also changed over time, with greater use of dye injection in the early reports, 2,3,5,11-14 bigger size of needle, and amniocentesis performed in earlier gestation. [2][3][4]8,9,[15][16][17] Tables 3 and 4 show the outcomes of multiple pregnancies after amniocentesis and CVS, quoted from studies published in the last 20 years. Earlier reports described the spontaneous abortion rate up to 28 weeks.…”

Section: Discussionmentioning

confidence: 99%

Outcome of twin pregnancies after amniocentesis

Kan¹,

Lee²,

Leung³

et al. 2012

J of Obstet and Gynaecol

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Section: Discussionmentioning

confidence: 99%

Outcome of twin pregnancies after amniocentesis

Kan¹,

Lee²,

Leung³

et al. 2012

J of Obstet and Gynaecol

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“…Methylene blue used as a marker dye in the past has been linked to certain toxic manifestations such as fetal hemolysis, fetal small bowel atresias and fetal death. [35][36][37][38][39][40] Nevertheless, the high resolution ultrasound equipment currently available, in expertise hands, may ensure accurate sampling from each sac, 41,42 reserving the installation of dye for cases of amniotic volume discordance where detection of the septum is uncertain or high-order pregnancies where documentation and »labeling« of sacs turn out insecure. 43 An alternative approach first described by Jeanty et al in 1990 is the single uterine entry technique or single needle insertion technique.…”

Section: Amniocentesismentioning

confidence: 99%

Invasive Diagnostic Procedures in Multiple Pregnancies

Antsaklis¹,

Partsinevelos²

2008

Donald School Textbook of Interventional Ultrasound

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Over the past few years, the rising rate of multiple pregnancies, attributed to both increasing reliance on infertility treatment modalities and delayed childbearing, has expanded the need for prenatal invasive genetic testing. In multiples, first-trimester chorionic villus sampling and second-trimester amniocentesis are relatively safe and efficient alternative procedures, whereas fetal blood sampling is reserved for cases where an indefinite result of fetal karyotyping needs elucidation. The choice of invasive technique should be based on gestational age at referral date, procedure related risks and technical demands, but experience of the center performing the modality should be emphasized in decision making. Technological advances in modern high resolution ultrasound equipment along with increasing operator experience available today result in more accurate and efficacious invasive prenatal diagnosis in twin or higher-order pregnancies, minimizing potential post-procedural fetal loss rate. PregledKlju~ne rije~i: genetsko testiranje, vi{eplodna trudno}a, prenatalna dijagnostika SA@ETAK. Monozigotni blizanci~ine oko 30% blizana~kih trudno}a, njihova je u~estalost stalna, a dvozigotni blizancĩ ine oko 70% blizana~kih trudno}a, njihova je u~estalost u porastu, zbog u~estale primjene tehnike pomognute oplodnje i zbog odga|anja prvih trudno}a te posljedi~ne ve}e`ivotne dobi trudnica. Rizik strukturalnih anomalija u blizanaca je ve}a nego u jednoplodnih trudno}a, rizik je do tri puta ve}i u monozigotnih, a u dizigotnih blizanaca je od prilike kao u jednoplodnih trudno}a. Zbog ukupno ve}e u~estalosti vi{eplodnih trudno}a pove}ana je potreba za invazivnom prenatalnom dijagnostikom. U vi{eplodnim trudno}ama su biopsija korionskih resica u prvom i amniocenteza u drugom tromjese~ju relativno sigurni i uspje{ni alternativni postupci, a uzimanje fetalne krvi kordocentezom je rezervirano za slu~ajeve kada je u~injena kariotipizacija fetusa nesigurna i nejasna. Izbor invazivne tehnike se temelji na dobi trudno}e kad se trudnica javlja, na postoje}i rizik postupka i na tehni~ke zahtjeve, a od velikog je zna~aja iskustvo prenatalnog centra. Tehnolo{ki napredak suvremene ultrazvu~ne aparature te rastu}e iskustvo prenatalnog operatera doprinose to~noj i u~inkovitijoj invazivnoj prenatalnoj dijagnostici u dvojaka i blizanaca vi{eg stupnja te na najmanju mogu}u mjeru smanjuju fetalni gubitak nakon invazivnog postupka. Gynaecol Perinatol 2008;17(1):15-21 Antsaklis A. J., Partsinevelos G. A. Invasive diagnostic procedures in multiple pregnancies Paper

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“…The choice of the invasive prenatal diagnostic procedure (CVS or amniocentesis) depends on the level of risk and the likelihood to proceed to SF. CVS yields rapid karyotyping results that allow performing SF at earlier gestations . In our series, 15 cases underwent SF at a median gestational age of 11.9 weeks after CVS.…”

Section: Discussionmentioning

confidence: 96%

“…Comparing procedure‐related pregnancy losses between twin and singleton pregnancies, Pergament et al found that CVS performed for twin pregnancies was not associated with higher risks compared to singleton pregnancies . Comparing the outcomes after CVS and amniocentesis in twins revealed that the miscarriage rate was about 3.39–4.5% and 2.9–4.2% and the total fetal loss rate was 3.9–13.6% and 6.1–9.3% in CVS and amniocentesis, respectively, concluding that both procedures are comparable …”

Section: Discussionmentioning

confidence: 99%

Obstetrical outcomes after first‐trimester chorionic villus sampling in twin pregnancies: A retrospective case–control study

Kim

Ahn

Lee

et al. 2019

J of Obstet and Gynaecol

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Aim: Prenatal diagnostic testing by chorionic villus sampling (CVS) is sometimes recommended for women with twin pregnancies. However, few studies have compared the outcomes between twins with CVS and control twins without intervention. This study aimed to compare the obstetrical outcomes of CVS in twin pregnancies and those in non-intervention twin pregnancies. Methods: First-trimester transabdominal CVS was performed on dichorionic-diamniotic twins (n = 54; Group 1) between December 2006 and January 2017 at the Department of Obstetrics and Gynecology at our hospital, and the data were retrospectively analyzed. CVS risks were evaluated by comparing obstetrical outcomes with those of a control population of 155 dichorionic-diamniotic twins without intervention (Group 2). Results: The difference in the overall fetal loss rate (Group 1, 7.4% vs Group 2, 3.9%; P = 0.287) between the two groups was not statistically significant. The miscarriage rate, defined as delivery at <24 gestational weeks, and early preterm delivery, defined as delivery at <34 gestational weeks, were not significant between the groups (miscarriage: Group 1, 5.6% vs Group 2, 3.2%; P = 0.428; early preterm delivery: Group 1, 11.1% vs Group 2, 9.0%; P = 0.788). The mean gestational age at delivery, birth weights and neonatal intensive care unit admission rate were not statistically significant between the groups. Thus, the overall fetal loss rate and obstetrical outcomes of Group 1 were comparable with those of Group 2. Conclusion: In conclusion, the overall obstetrical outcomes were not significantly different between twins with CVS and control twins with the advantage of enabling early decision-making about selective feticide in twins with CVS.

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Second‐trimester amniocentesis vs. chorionic villus sampling for prenatal diagnosis in multiple gestations

Abstract: Chorionic villus sampling appears to be a safe alternative to amniocentesis and should be considered as the method of choice particularly when there is a high risk of an affected fetus necessitating selective feticide.

Cited by 56 publications

References 41 publications

Outcome of twin pregnancies after amniocentesis

Outcome of twin pregnancies after amniocentesis

Invasive Diagnostic Procedures in Multiple Pregnancies

Obstetrical outcomes after first‐trimester chorionic villus sampling in twin pregnancies: A retrospective case–control study

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