Transcervical, Transabdominal and Transvaginal Chorionic Villus Sampling for Prenatal Diagnosis in Zagreb: 5500 Cases under a Single Operator

Objectives: This prospective, monocentric, randomized study examined data from 5500 women underwent transcervical (TC-CVS), transabdominal (TA-CVS) and transvaginal (TV-CVS), by a single operator. We assessed the efficacy of transabdominal CVS compared with transcervical and transvaginal CVS, and examined factors implicated in causing spontaneous abortion. Methods: Over a fifteen year’s period 5500 women underwent chorionic villus sampling at 10-14 weeks of gestation, by transcervical, (850 patients) transabdominal (4500 patients) and transvaginal technique (150 patients).Results: In total 850 (15.5 per cent) patients underwent transcervical CVS (TC-CVS) using a flexible catheter and spontaneous abortion rate after TC-CVS occurred following the procedure in five cases (0.6 per cent). Additionaly,4500 (81.8 per cent) patients underwent transabdominal CVS (TA-CVS) using a 20-gauge spinal needle after which spontaneous abortion occurred in eight women (0.18 per cent). Transvaginal CVS (TV-CVS) was performed in 150 (2.7 per cent) patients using a 20 gauge needle and spontaneous abortion after TV-CVS occurred in two cases (1.3 per cent). In eighty (4.0 per cent) patients’ chromosomal aberration was detected. The rate of spontaneous abortion rate was lower among women who underwent TA-CVS after 13 weeks of gestation. There were no significant differences found in mean pulsatility indices (PIs) between maternal end fetal circulation, before and after CVS procedures, using transvaginal color doppler. Conclusions Transabdominal CVS is associated with a lower fetal loss rate than transcervical and transvaginal CVS.