Brambati Bruno, Tului Lucia, Camurri Lamberto, Guercilena Stefano
First Department of Obstetrics and Gynaecology, University of Milan, Italy.
Prenat Diagn. 2002 Oct;22(10):907-13. doi: 10.1002/pd.435.
To assess feasibility, effectiveness and risk of prenatal diagnosis by TA-CVS at 13-14 and 15-20 weeks' gestation.
CVS was performed transabdominally by free-hand single needle insertion technique under continuous ultrasound visualization on 1844 pregnant women, aged 18 to 48, at 13 to 20 weeks' gestation, whose primary indication was chromosomal anomalies and single gene defects in 85% and 15% of cases, respectively Clinical follow-up of women undergoing TA-CVS at 13 to 20 weeks' was prospectively obtained; the population was split in two groups of 13-14 (series B) and 15-20 weeks' (series C) gestation. Statistical evaluation included a group of TA-CVS cases performed at 11-12 weeks (series A).
Sampling was feasible in 98.2%, 99.1% and 95.8% of cases of series A, B and C, respectively. Sampling was successful in all cases of the three series and a second insertion was required in 1.5%, 1.3% and 0.9%, respectively. A trend towards lower fetal loss rate is apparent (1.02%, 0.86%, and 0.46 in series A, B, and C, respectively), although differences were not statistically significant. No post-procedural complications were reported for series B and C, while spotting was present in 1.8% of cases for series A. Karyotyping was totally successful by short term culture and was also available by long term culture in 99% of cases for series A, B and C when the amount of chorionic tissue was more than 15 mg.
TA-CVS appears highly effective and safe and might be offered as a valuable alternative to early as well as mid-trimester amniocentesis.
评估在妊娠13 - 14周和15 - 20周时经腹绒毛取样术（TA - CVS）进行产前诊断的可行性、有效性及风险。
对1844例年龄在18至48岁、妊娠13至20周的孕妇，在持续超声引导下采用徒手单针穿刺技术经腹进行绒毛取样术。这些孕妇的主要指征分别为85%的染色体异常和15%的单基因缺陷。对妊娠13至20周接受TA - CVS的孕妇进行前瞻性临床随访；将人群分为妊娠13 - 14周（B组）和15 - 20周（C组）两组。统计评估包括一组在11 - 12周进行TA - CVS的病例（A组）。
A组、B组和C组病例的取样可行性分别为98.2%、99.1%和95.8%。三个系列的所有病例取样均成功，再次穿刺的比例分别为1.5%、1.3%和0.9%。胎儿丢失率有降低趋势（A组、B组和C组分别为1.02%、0.86%和0.46%），尽管差异无统计学意义。B组和C组未报告术后并发症，而A组有1.8%的病例出现少量阴道出血。当绒毛组织量超过15mg时，A组、B组和C组通过短期培养进行核型分析完全成功，99%的病例通过长期培养也可获得结果。
经腹绒毛取样术似乎高效且安全，可作为孕早期和孕中期羊膜腔穿刺术的一种有价值的替代方法。
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