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Early and late chorionic villus sampling in Zagreb: experience with 9500 cases

Objective. To evaluate the association between early and late chorionic villus sampling (CVS) and complications between sampling and delivery. Methods. This study comprises data from 4000 (42%) women allocated to early transabdominal CVS (TA-CVS) and 5500 (48%) women allocated to late CVS (placental biopsy). Over a 18th year period 4000 women underwent CVS at 10-12 weeks of gestation. Late CVS under ultrasound guidance was carried out in 4700 cases in the second trimester and 800 (8, 4%) cases in the third trimester of pregnancy. Transabdominal color Doppler was used to investigate the uteroplacental and fetal vessels in 4000 patients between 11 and 12 weeks of gestation and in 4000 patients between 13 and 20 weeks of gestation before and after chorionic villus sampling. Results. Spontaneous abortion after early TA-CVS occurred in 15 cases (0, 38%) out of 4000 patients. The spontaneous abortion rate was lower among cases allocated to TA-CVS after 11 weeks of gestation. 135 (3, 3%) cases showed chromosomal aberrations. 5500 patients underwent late TA-CVS and spontaneous abortion ocurred in 13 (0, 28%). We found 200 (4, 0%) chromosomal abnormalities, in 102 (51%) of them ultrasonographic findings were detected after 20th week of pregnancy. In the group with suspicious ultrasonographic findings (933 cases) we found oligohydramnios in 395 (42, 3%) and polyhydramnios in 227 (24, 3%) ; 133 (14, 2%) of them had chromosomal abnormalities. There were no significant differences in mean pulsatility indices in uteroplacental and fetal vessels before and after CVS procedures. Data for 55 trisomic fetuses (45 trisomy 21, five trisomy 18 and five trisomy 13) indicate an abnormally increased umbilical and ductus venosus PI and abnormally decreased middle cerebral artery PI. Conclusions. CVS is a safe method of prenatal diagnosis for high-risk couples and does not significantly affect the pregnancy. Late CVS has lower fetal loss rate than early transabdominal CVS.

CVS; chromosomal abberations; spontaneus abortion rate

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