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Chorionic villus sampling: 10 years of experience in a University referral center - 18/02/20

Doi : 10.1016/j.jogoh.2020.101715 
Ana Teresa Martins a, , Carla Francisco b, Hildeberto Correia c, Álvaro Cohen d
a Prenatal Diagnosis Unit, Dr. Alfredo da Costa Maternity, Lisbon Central University Hospital Center, University assistant of Obstetrics and Gynecology, Nova Medical School, Lisbon, Portugal 
b Prenatal Diagnosis Unit, Dr. Alfredo da Costa Maternity, Lisbon Central University Hospital, Nova Medical School, Lisbon, Portugal 
c Department of Medical Genetics of INSA (Instituto Nacional de Saúde Doutor Ricardo Jorge), Lisbon, Portugal 
d Prenatal Diagnosis Unit, Dr. Alfredo da Costa Maternity, Lisbon Central University Hospital Center, Lisbon, Portugal 

Corresponding author at: Centro de Diagnóstico Pré-Natal, Maternidade Dr. Alfredo da Costa, Rua Viriato, 1069-089, Lisboa, Portugal.Centro de Diagnóstico Pré-NatalMaternidade Dr. Alfredo da Costa, Rua ViriatoLisboa1069-089Portugal
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Abstract

Objectives

The purpose of this study was to estimate our center-specific CVS-related miscarriage rate.

Methods

This is an observational retrospective study of women submitted to a CVS in our hospital, between January 1st, 2007 and December 31st, 2016. Maternal and pregnancy characteristics, procedure details, genetic results and pregnancy outcomes of all patients were collected. The FMF miscarriage risk algorithm was used to estimate our population expected risk of miscarriage. To establish the procedure-related risk of miscarriage, we compared the observed with the expected miscarriage rate.

Results

We had a total number of 1523 women with a singleton pregnancy who did a CVS over the 10-year period. The mean maternal age was 34 years old; the majority of the women was Caucasian, multiparous and had a spontaneous pregnancy. The most common indication for CVS was a high-risk result in the 1st trimester combined screening test. The karyotype was normal in 72,7% of cases, 11,1% were T21 and 7,2% were T13 or T18.

In the study group, 33 women were diagnosed with a fetal demise, 435 had a TOP and there were 4 intrauterine deaths and 34 miscarriages. The rate of miscarriage in our population was 3,2% and the expected patient specific risk for miscarriage was 3,0%. There was no statistical significance between the two miscarriage rates (p = 0,705).

Conclusion

In our study the risk of miscarriage in the CVS group was not significantly different from that the expected patient specific risk (3.2% vs 3%, p = 0.7).

The procedure-related risk of miscarriage was 0,2%, similar to the rates describe in the literature. An accurate risk of pregnancy loss should be used when counseling women for CVS to allow an informed decision.

Le texte complet de cet article est disponible en PDF.

Keywords : prenatal diagnosis, First-trimester screening, Chorionic villus sampling, Miscarriage, Procedure-related risk of fetal loss


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