ABSTRACT
Purpose: To compare the adverse pregnancy outcomes between the pregnant women undergoing chorionic villous sampling (CVS) and those without CVS.Materials and methods: A cohort study was conducted on low risk pregnancies attending Chiang Mai University Hospital between years 2003 and 2017 and identify the database of women undergoing CVS (study group) and control group. Each case in study group was matched for 10 cases of the control by maternal age and year of procedure.Results and conclusions: Of 1384 pregnancies undergoing CVS, 776 cases met criteria and were matched with 7760 controls. The gestational age at delivery and actual birth weight were significantly different between two groups (38.02 versus 38.96 weeks, p value <.001 and 3025 versus 3092 g, p value .001). Moreover, CVS group had significantly higher preterm birth (9.4 versus 7.3%, p value .037; RR 1.287, 95% CI 1.017-1.629). However, there was no significant difference in fetal loss rate before 24 weeks (1.16 versus 1.9%, p value .14), small for gestational age (SGA); SGA (4 versus 4%, p value .948) and low birth weight (LBW); LBW (8.9 versus 8.0%, p value .41). Pregnancies undergoing CVS tend to deliver earlier and has significantly higher preterm birth. However, the incidences of fetal loss, SGA and LBW are not significantly increased.
Subject(s)
Chorionic Villi Sampling/adverse effects , Fetal Death/etiology , Fetal Growth Retardation/etiology , Infant, Low Birth Weight , Infant, Small for Gestational Age , Premature Birth/etiology , Adolescent , Adult , Female , Fetal Growth Retardation/epidemiology , Humans , Infant, Newborn , Male , Middle Aged , Pregnancy , Premature Birth/epidemiology , Retrospective Studies , Risk Factors , Young AdultABSTRACT
OBJECTIVE: To compare red blood cell indices among normal, beta-thalassemia trait or hemoglobin (Hb) E trait, and beta-thalassemia/Hb E diseases mid-gestational fetuses. METHODS: One hundred seventy-five fetuses at risk of beta-thalassemia/Hb E disease undergoing cordocentesis with determination of Hb levels and red blood cell indices at mid-pregnancy were recruited. The fetal diagnoses were based on fetal Hb typing and DNA analysis. The fetuses were divided into three groups: normal, beta-thalassemia trait or Hb E trait, and beta-thalassemia/Hb E disease. RESULTS: The prevalence of beta-thalassemia/Hb E disease, beta-thalassemia trait or Hb E trait, and normal fetuses was 32.6% (57 cases), 28.6% (50 cases) and 36.6% (64 cases), respectively. Mean Hb levels and red blood cell indices were not significantly different among the three groups of fetuses. However, almost 10% of beta-thalassemia/Hb E fetuses had some degree of anemia. The most anemic fetuses had a ß(0) mutation. CONCLUSION: There is no significant difference in Hb level and red blood cell indices among fetuses at risk of beta-thalassemia/Hb E disease.
Subject(s)
Erythrocyte Indices , Fetal Hemoglobin/analysis , Hemoglobin E/analysis , Pregnancy Trimester, Second/blood , beta-Thalassemia/blood , Case-Control Studies , Cordocentesis , Female , Gestational Age , Hemoglobin E/genetics , Humans , Mutation , Pregnancy , Prenatal Diagnosis/statistics & numerical data , beta-Thalassemia/diagnosis , beta-Thalassemia/epidemiology , beta-Thalassemia/geneticsABSTRACT
OBJECTIVE: To describe the technical aspects and complications of chorionic villous sampling (CVS). MATERIAL AND METHOD: The database of CVS procedures performed between January 2004 and August 2011 at Maharaj Nakorn Chiang Mai Hospital was assessed prospectively. Consecutive procedures during 10 to 14 gestational weeks were included into the present study. Indications, results, and complications of the CVS were extracted and analyzed. RESULTS: All 636 CVS procedures were successful. Indications for CVS were fetal karyotyping, DNA analysis for severe thalassemia disease, and for both in 36.5%, 50. 6%, and 12.9%, respectively However, 3.4% had inconclusive CVS result, and the second trimester prenatal diagnosis procedures needed to be done. There were five cases (0.8%) of fetal loss in the present study. Only two cases (0.3%) that fetal loss happened within two weeks of CVS procedures. Other minor complications such as vaginal bleeding and amniotic fluid leakage were found in 0.3 to 1.3% and had no long-term effect. No case with anomaly and procedure-related infection following the procedure was seen. CONCLUSION: CVS is a safe and reliable prenatal diagnosis procedure in the first trimester. In experienced operators, fetal loss rate was less than 1%. However a few cases will have inconclusive CVS results and may need a confirmation during the second trimester diagnostic procedures.
