PREGNANCY OUTCOME AFTER TRANSCERVICAL CVS WITH A FLEXIBLE BIOPSY FORCEPS - EVALUATION OF RISK-FACTORS

The pregnancy outcome of 1936 women who had transcervical chorionic vi llus sampling (CVS) with a flexible biopsy forceps was evaluated. Foll ow-up until 4 weeks after delivery was 99.4 per cent. Various patient- and procedure-related risk factors for spontaneous loss (fetal or neo natal death) were analysed using stepwise logistic regression analysis . The overall spontaneous loss rate was 4.5 per cent. Factors found to be significantly associated with spontaneous loss were quantity of vi lli less than or equal to 15 mg (relative risk (RR) 2.13), a history o f first-trimester miscarriage (RR 1.87) or delivery between 16 and 21 weeks (RR 3.87), cervical culture positive for anaerobes (RR 4.52) or group B streptococcus (RR 3.62), post-procedural bleeding >3 days (RR 1.99), and multiple insertions (RR 2.64). Significant differences in l oss rates between individual operators were found. A learning effect w as not present. There were no infants born with terminal transversal l imb anomalies in our series. We conclude that knowledge about signific ant risk factors for spontaneous loss after CVS is important both for obstetricians carrying out CVS procedures and for women seeking prenat al diagnosis.