Procedure-Related Complications after Genetic Amniocentesis and Chorionic Villus Sampling

Abstract

Purpose: Amniocentesis (AC) and chorionic villus sampling (CVS) play an important role in the diagnosis of genetic anomalies. The aim of this study was to evaluate presentable numbers of procedure-related complications of genetic interventions in a tertiary referral hospital.

Materials and Methods: The pregnancy outcome of women who underwent genetic AC or CVS during 2003 – 2010 at the Department of Obstetrics and Gynecology, Medical University of Graz, Austria, was analyzed retrospectively. The primary outcome was miscarriage or membrane rupture after an invasive procedure. Only singleton gestations were included.

Results: 1,569 AC procedures and 334 CVS procedures (234 transabdominal, 99 transcervical, 1 with undocumented route) were performed. Of these, 57 cases were excluded from further analysis because of severe anomalies. Complete outcome data were available for 93.17 % of cases. In 164 (8.89 %) cases the pregnancy was terminated due to genetic anomalies or severe malformations. In the remaining collective 10 of 1,342 (0.75 %) AC procedures, 3 of 150 (2.00 %) transabdominal CVS procedures and 2 of 64 (3.13 %) transcervical CVS procedures lead to complications resulting in miscarriage < 24 weeks (n = 13) or rupture of membranes (n = 2) within 2 weeks after procedure. Complication rates were significantly higher after CVS than after AC (OR 3.19).

Conclusion: Over an observation period of seven years, the complication rates after AC, transabdominal CVS and transcervical CVS were 0.75 %, 2.00 % and 3.13 %, respectively. These results are comparable to recent international investigations.

Zusammenfassung

Ziel: Invasive pränatale Untersuchungen, wie Amniozentese (AC) und Chorionzottenbiopsie (CVS), spielen eine entscheidende Rolle in der Diagnostik genetischer Anomalien. Ziel der vorliegenden Studie ist die Ermittlung repräsentativer Zahlen über die Komplikationen nach genetischen Eingriffen in einem Tertiärzentrum.

Material und Methoden: In einer retrospektiven Analyse wurde das Outcome der an der Universitätsklinik für Frauenheilkunde und Geburtshilfe in Graz zwischen 2003 und 2010 betreuten Einlingsschwangerschaften, bei denen eine genetische AC oder CVS durchgeführt wurde, evaluiert. Primäres Outcome war das Auftreten einer Fehlgeburt oder eines Blasensprungs nach einem invasiven Eingriff.

Ergebnisse: Von den 1569 AC und 334 CVS (234 transabdominal, 99 transzervikal, 1 mit undokumentiertem Zugang) wurden 57 Fälle wegen schwerer kongenitaler Anomalien ausgeschlossen. Vollständige Daten konnten in 93,17 % erhoben werden. In 164 (8,89 %) Fällen wurde wegen genetischer oder struktureller Fehlbildungen ein Schwangerschaftsabbruch durchgeführt. Im restlichen Kollektiv kam es in 10 von 1342 (0,75 %) AC, 3 von 150 (2,00 %) transabdominalen CVS und 2 von 64 (3,13 %) transzervikalen CVS zu Komplikationen, die zu einer Fehlgeburt vor 24 SSW (n = 13) oder einem vorzeitigen Blasensprung (n = 2) innerhalb von 2 Wochen nach dem Eingriff führten. Die Komplikationsraten nach CVS waren höher als nach AC (OR 3,19).

Schlussfolgerung: Über einen 7-jährigen Beobachtungszeitraum betrugen die Komplikationsraten nach AC, transabdominaler und transzervikaler CVS 0,75 %, 2,00 % und 3,13 %. Dies ist vergleichbar mit neueren internationalen Untersuchungen.

Key words

obstetrcis - pregnancy - amniocentesis - chorionic villus - sampling

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