engleski

Late chorionic villus sampling in high risk pregnancies.

Objective:The purpose of this article was to evaluate the association between late CVS(placental biopsy) and complications between sampling and delivery.Design& methods:Late chorionic villus sampling under ultrasound guidance was carried out in 2600(86,7per cent) cases in the second trimester and 400 (13,3per cent) cases in the third trimester of pregnancy.Out of 3000 late CVS, 684(22.8per cent) were performed because of suspicious ultrasonographic findings In all patients the fetal heart rate was measured by M-mode and in the 500 patients between 13 and 16 weeks of gestation colour Doppler was used to investigate the uteroplacental and fetal vessels before and after late chorionic villus sampling.In the same group, mean serum alpha- fetoprotein was determined before and after sampling. Results: In 24 patients(0,8 per cent), complications between sampling and delivery were found. There were only nine (0.35 per cent) spontaneous abortions four to six weeks after late chorionic villus sampling.However, there was no correlation between alpha-fetoprotein elevation, placental haematoma, Doppler measurements and spontaneous abortion. We found 156 (5.2 per cent) chromosomal abnormalities. In the group with suspicious ultrasonic findings (684 cases) we found significant oligohydramnios in 300 (43,8 per cent) and significant polyhydramnios in 150 (21,9 per cent), and 105 (15,4 per cent) had chromosomal abnormalities . Among the 156 patients with chromosomal abnormalities, ultrasonographic findings in 85(54,4 per cent) were detected after 20th week of pregnancy. There were no significant differences in mean pulsatility indices between uteroplacental and fetal vessels before and after late chorionic villus sampling. Preliminary data for twenty trisomic fetuses indicate an abnormally increased umbilical PI and abnormally decreased middle cerebral artery PI.Conclusions: Late CVS is a safe method of prenatal diagnosis for high-risk couples and does not significantly affect the outcome of pregnancy.

Late CVS; placental biopsy; color Doppler

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