Dl. Byrne et al., FIRST TRIMESTER AMNIFILTRATION - TECHNICAL, CYTOGENETIC AND PREGNANCYOUTCOME OF 104 CONSECUTIVE PROCEDURES, British journal of obstetrics and gynaecology, 102(3), 1995, pp. 220-223
Objective To investigate the technical, cytogenetic and pregnancy comp
lications of first trimester amnifiltration for the diagnosis of fetal
karyotype. Design Observational study. Setting The fetal medicine uni
t, UMDS St Thomas' Campus, London. Subjects One hundred and four women
seeking prenatal diagnosis of fetal karyotype. Main outcome measures
Sampling success, culture rate, harvest time and karyotype, pregnancy
outcome and complications. Results Sampling was successful in all 104
cases, but equipment failure forced the procedure to be changed to ear
ly amniocentesis in eight (7%) cases. The karyotype was normal in 101
(97%) cases, abnormal in three. The mean harvest time was 14 days (ran
ge 9-26 days; SD = 3.4), and three cultures failed (2.8%). Pregnancies
resulted in 99 (95%) live births, with a mean gestation of 277 days (
range 182-300 days; SD = 16). There was one termination for trisomy 21
and four spontaneous miscarriages (3.8%). Amniotic fluid leakage occu
rred in six cases (5%), all resulted in live births, five at term and
one at 35 weeks. Conclusions This study demonstrates that amnifiltrati
on is technically possible in the first trimester of pregnancy, and th
at samples can be successfully karyotyped. The harvest time for cultur
e is similar to early amniocentesis and chorion villus sampling. The r
ate of fetal loss, adjusted by the estimated natural loss, is 1.7%, wh
ich compares favourably with both chorionic villus sampling and early
amniocentesis.