Chevreau Julien, Becart Lucie, Sergent Fabrice, Foulon Arthur, Gondry Jean, Jedraszak Guillaume
Department of Obstetrics and Gynecology, University Hospital of Amiens, CHU Amiens-Picardie, Amiens, France.
Department of Genetics, University Hospital of Amiens, CHU Amiens-Picardie, Amiens, France.
J Matern Fetal Neonatal Med. 2022 Jan;35(1):141-146. doi: 10.1080/14767058.2020.1712713. Epub 2020 Jan 12.
Chorionic villus sampling (CVS) allows for earlier results for aneuploidy or genomic abnormalities compared to amniocentesis. Nevertheless, the inability to provide complete results has been described as being more frequent with CVS. This study was conducted in order to identify risk factors for such failures.
A retrospective single-center study was performed from January 2014 to December 2018. Participants were divided into two groups depending on whether complete CVS results were issued ("successful CVS group") or not ("failed CVS group"). Failure affected preliminary short-term cultures, long-term cultures, or both.
During the study period, 214 CVS were performed, 73 (34%) of which were classified in the failed CVS group. We observed significant intergroup differences between the successful and failed CVS groups for four variables: BMI (respectively 23.9 [±5.88] and 25.9 [±6.13] kg/m), term at sampling (12.9 [±1.35] and 12.6 [±1.09] weeks gestation), trophoblastic location (posterior in 49 [40%] and 37 [66%] cases), and sampling approach (transcervical in 54 [43%] and 36 [64%] cases) ( < .05). In a stepwise binary logistic regression analysis, higher BMI, posterior trophoblastic location, and transcervical sampling approach were the only variables negatively influencing CVS success, with respective aOR [95% CI] of 0.947 [0.898; 0.996], 0.322 [0.160; 0.634], and 0.466 [0.238; 0.900].
In the presence of CVS failure risk factors, a discussion could be initiated regarding a deferred amniocentesis as a first option.
与羊膜腔穿刺术相比，绒毛取样（CVS）能更早得出非整倍体或基因组异常的结果。然而，已有描述称CVS无法提供完整结果的情况更为常见。本研究旨在确定此类失败的风险因素。
2014年1月至2018年12月进行了一项回顾性单中心研究。根据是否发布完整的CVS结果，将参与者分为两组（“CVS成功组”和“CVS失败组”）。失败影响初步短期培养、长期培养或两者。
在研究期间，共进行了214次CVS，其中73次（34%）被归类为CVS失败组。我们观察到成功和失败的CVS组在四个变量上存在显著的组间差异：体重指数（分别为23.9[±5.88]和25.9[±6.13]kg/m）、取样孕周（12.9[±1.35]和12.6[±1.09]周妊娠）、滋养层位置（49例[40%]和37例[66%]为后壁）以及取样方法（经宫颈取样分别为54例[43%]和36例[64%]）（P<0.05）。在逐步二元逻辑回归分析中，较高的体重指数、滋养层后壁位置和经宫颈取样方法是仅有的对CVS成功有负面影响的变量，其调整后比值比[aOR，95%置信区间]分别为0.947[0.898；0.996]、0.322[0.160；0.634]和0.466[0.238；0.900]。
存在CVS失败风险因素时，可首先讨论推迟进行羊膜腔穿刺术。
