Transabdominal villus sampling in early second trimester: A safe sampling method for women of advanced age

Abstract

Transabdominal chorionic villus sampling (TA-CVS) was performed in 707 viable singleton pregnancies to exclude chromosomal abnormalities. Maternal age ranged between 36 and 49 years (mean 37.9 years); gestational age varied between 10.2 and 18.3 weeks (mean 13.3 weeks). In 639 women (90.4 per cent), a sufficient amount of chorionic tissue (greater than or equal to 10 mg) was obtained after one needle insertion; in 66 women (9.3 per cent) two insertions were needed. An abnormal chromosome pattern was established in 19 cases (2.9 per cent). Vaginal bleeding or spotting within 28 days after TA-CVS occurred in 11 cases (1.5 per cent). The completed follow-up of 678 chromosomally normal pregnancies showed an overall fetal loss rate of 2.6 per cent before 28 weeks. The overall perinatal mortality was 0.9 per cent. When relating fetal loss to gestational age at TA-CVS, this was 6.6 per cent in women sampled before 12 weeks against only 1.8 per cent after 12 weeks. At the same time, the percentage of fetal loss occurring within 2 weeks following the procedure was 75 and 30 per cent, respectively. It is suggested that these data reflect the decline in spontaneous abortion rate during this particular period of pregnancy. It is concluded that TA-CVS is an effective procedure which, when performed after the natural decrease of fetal loss, appears to be a safe option for women of advanced maternal age.

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

“…The number of sampling device insertions, one or two, did not influence the pregnancy outcome either in the transabdominal (3·2 per cent vs. 3·2 per cent) or in the transcervical (4·6 per cent vs. 5·29 per cent) cases. This is consistent with the findings of other investigators, who in addition observed that more than two insertions were associated with a higher loss rate (Hogge et al, 1986;Rhoads et al, 1989;Jahoda et al, 1990;Williams et al, 1992). This substantiates our protocol of limiting to two the number of device insertions in a single sampling session.…”

Accuracy of abnormal karyotypes after the analysis of both short- and long-term culture of chorionic villi

“…Chorionic villus samples were obtained under continuous ultrasound guidance by transabdominal aspiration as described previously (Jahoda et al, 1990). At least 20 mg of villi are required for chromosomal analysis of both STC-and LTC-villi in those cases where the indication for prenatal diagnosis is cytogenetic only.…”

Prospective prenatal investigations on potential uniparental disomy in cases of confined placental trisomy

“…Five to 35 mg (mean 14 mg) of chorionic villi was sampled transabdominally at 11-14 weeks of gestation as described previously (Jahoda et al, 1990). Indications for prenatal diagnosis were advanced maternal age (_36 years) (n=20), risk of X-linked mental retardation, recurrence risk of Niemann Pick type A, and risk of X-linked adrenomyeloneuropathy (each n=1).…”