Casals Gemma, Borrell Antoni, Martínez Josep M, Soler Anna, Cararach Vicenç, Fortuny Albert
Prenatal Diagnosis Unit, Department of Obstetrics and Gynecology, Hospital Clínic, University of Barcelona Medical School, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.
Prenat Diagn. 2002 Mar;22(3):260-5.
The aim of this study was to assess the effectiveness and safety of chorionic villus sampling (CVS) performed in multiple pregnancies by means of a transcervical biopsy forceps.
The study included CVS performed from January 1990 to March 2000 in our Unit. The results were analysed in two consecutive periods, period A (1990-1994) and period B (1995-2000), in an attempt to assess the effect of increasing experience.
Seventy-five samplings were performed in 39 multiple pregnancies, 38 twin sets and one triplet. A cytogenetic report was obtained in 73% of cases in period A and in 98% in period B. An abnormal karyotype was observed in 11 samples. The need for subsequent amniocentesis decreased from 38% in period A to 10% in period B. The spontaneous fetal loss rate in chromosomally and structurally normal fetuses before the 20th week decreased from 8.7% in period A to 3.3% in period B. The fetal loss rate after the 20th week was 3.3% in period B and none in period A. It must be noted that in three out of the four cases of fetal loss an amniocentesis was needed after CVS.
Our results suggest that effectiveness and safety improved with increasing experience. Transcervical chorionic villus sampling allows an earlier prenatal genetic diagnosis in multiple pregnancies and this may be particularly relevant for a safer selective termination when chosen by parents if one of the fetuses has an abnormal karyotype.
本研究旨在评估经宫颈活检钳在多胎妊娠中进行绒毛取样（CVS）的有效性和安全性。
本研究纳入了1990年1月至2000年3月在我们科室进行的CVS。结果在两个连续时期进行分析，A期（1990 - 1994年）和B期（1995 - 2000年），以评估经验增加的影响。
对39例多胎妊娠进行了75次取样，其中38对双胞胎和1例三胞胎。A期73%的病例获得了细胞遗传学报告，B期为98%。在11个样本中观察到异常核型。后续羊膜穿刺术的需求从A期的38%降至B期的10%。20周前染色体和结构正常胎儿的自然流产率从A期的8.7%降至B期的3.3%。B期20周后的胎儿丢失率为3.3%，A期无胎儿丢失。必须指出的是，在四例胎儿丢失病例中有三例在CVS后需要进行羊膜穿刺术。
我们的结果表明，随着经验的增加，有效性和安全性得到了提高。经宫颈绒毛取样可在多胎妊娠中更早地进行产前基因诊断，当父母选择如果其中一个胎儿核型异常进行更安全的选择性终止妊娠时，这可能特别相关。
