Cagino Kristen, Chasen Stephen T
Department of Obstetrics and Gynecology, New York Presbyterian Weill Cornell Medical Center, New York.
Am J Perinatol. 2024 May;41(7):876-878. doi: 10.1055/a-1787-6785. Epub 2022 Mar 3.
Approximately, 2% of women who undergo chorionic villi sampling (CVS) will subsequently undergo amniocentesis due to placental mosaicism or sampling/laboratory issues. Our objective was to compare obstetric outcomes in women who underwent both procedures with those who had CVS alone.
Retrospective case-control study of patients with singleton pregnancies undergoing invasive testing from 2010 to 2020 was performed. All women who underwent CVS followed by amniocentesis were compared with a control group who underwent CVS alone matched (2:1) for age and year of pregnancy. Women with pregnancy loss at <16 weeks were excluded from the control group. Pregnancies terminated for genetic abnormalities were excluded. Obstetric outcomes were compared between cases and controls. Student -test and Fisher's exact test were used for statistical comparison.
During the study period 2,539 women underwent CVS, and 66 (2.6%) subsequently underwent amniocentesis. The 66 cases were compared with 132 age-matched controls who underwent CVS alone. Mean maternal age was 36.8 ± 3.4 years, and 43% of women were nulliparous. Amniocentesis was performed due to sampling or laboratory issues in 33% of cases, placental mosaicism in 44%, and further diagnostic testing in 23%. There were no pregnancy losses or stillbirths in either group. Those who had two invasive procedures delivered at similar gestational ages and birthweights and did not have higher rates of adverse outcomes compared with those who underwent CVS alone.
Patients considering CVS who are concerned about the possibility that a second invasive procedure could be required should be reassured that this does not appear to be associated with higher rates of adverse outcomes. Due to study size, we cannot exclude the possibility of small differences in uncommon outcomes, such as pregnancy loss or stillbirth.
· Amniocentesis may be recommended after CVS due to mosaicism, sampling issues, or further testing.. · Amniocentesis after CVS is not associated with pregnancy loss or other adverse outcomes compared.. · Patients who have both CVS and amniocentesis deliver at similar gestational ages and birthweights..
接受绒毛取样（CVS）的女性中，约2%随后会因胎盘嵌合体或取样/实验室问题而接受羊膜穿刺术。我们的目的是比较接受两种手术的女性与仅接受CVS的女性的产科结局。
对2010年至2020年接受侵入性检查的单胎妊娠患者进行回顾性病例对照研究。将所有先接受CVS后接受羊膜穿刺术的女性与年龄和妊娠年份匹配（2:1）的仅接受CVS的对照组进行比较。对照组排除妊娠16周前流产的女性。因基因异常而终止妊娠的情况被排除。比较病例组和对照组的产科结局。采用学生t检验和Fisher精确检验进行统计学比较。
在研究期间，2539名女性接受了CVS，其中66名（2.6%）随后接受了羊膜穿刺术。将这66例病例与132名年龄匹配的仅接受CVS的对照组进行比较。产妇平均年龄为36.8±3.4岁，43%的女性为初产妇。33%的病例因取样或实验室问题进行了羊膜穿刺术，44%因胎盘嵌合体，23%因进一步诊断检查。两组均无流产或死产情况。与仅接受CVS的女性相比，接受两种侵入性手术的女性在相似的孕周和出生体重时分娩，且不良结局发生率没有更高。
考虑进行CVS且担心可能需要进行第二次侵入性手术的患者应放心，这似乎与更高的不良结局发生率无关。由于研究规模的原因，我们不能排除在罕见结局（如流产或死产）中存在微小差异的可能性。
· 由于嵌合体、取样问题或进一步检测，CVS后可能会建议进行羊膜穿刺术。· CVS后进行羊膜穿刺术与流产或其他不良结局无关。· 接受CVS和羊膜穿刺术的患者在相似的孕周和出生体重时分娩。
