Amniocentesis and chorionic villus sampling for prenatal diagnosis

Evidence Summaries

Level of Evidence = A

Second trimester amniocentesis increases the risk of spontaneous miscarriage but is safer than transcervical chorionic villus sampling and early amniocentesis.

A Cochrane review 1 included 16 studies. Spontaneous miscarriages are more common following second trimester amniocentesis as compared with controls with no amniocentesis (2.1% vs. 1.3%; RR 1.02–2.52). Early amniocentesis is not a safe early alternative to second trimester amniocentesis because of increased pregnancy loss (7.6% vs. 5.9%; RR 1.29, 95% CI 1.03–1.61) and higher incidence of talipes compared to CVS (chorionic villus sampling) (RR 4.61; 95% CI 1.82 to 11.66).

Compared with second trimester amniocentesis, transcervical CVS carries a significantly higher risk of pregnancy loss (14.5% versus 11%; RR 1.40, 95% CI 1.09 to 1.81) and spontaneous miscarriage (12.9% versus 9.4%; RR 1.50, 95% CI 1.07 to 2.11). One study compared transabdominal CVS with second trimester amniocentesis and found no significant difference in the total pregnancy loss between the two procedures (6.3% versus 7%). Transcervical CVS is more technically demanding than transabdominal CVS with more failures to obtain sample and more multiple insertions.

References

1. Alfirevic Z, Sundberg K, Brigham S. Amniocentesis and chorionic villus sampling for prenatal diagnosis. Cochrane Database Syst Rev 2003;(3):CD003252 (Last assessed as up-to-date: 28 June 2008).  [PMID:12917956]


Copyright © 2017 Duodecim Medical Publications Limited.
Amniocentesis and chorionic villus sampling for prenatal diagnosis is a sample topic from the Evidence-Based Medicine Guidelines.

To view other topics, please or purchase a subscription.

Evidence Central is an integrated web and mobile solution that helps clinicians quickly answer etiology, diagnosis, treatment, and prognosis questions using the latest evidence-based research. Learn more.

Citation

* When formatting your citation, note that all book, journal, and database titles should be italicized* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Amniocentesis and chorionic villus sampling for prenatal diagnosis ID - 453380 BT - Evidence-Based Medicine Guidelines UR - https://evidence.unboundmedicine.com/evidence/view/EBMG/453380/all/Amniocentesis_and_chorionic_villus_sampling_for_prenatal_diagnosis PB - Duodecim Medical Publications Limited DB - Evidence Central DP - Unbound Medicine ER -