Lp. Shulman et al., AMNIOCENTESIS PERFORMED AT 14 WEEKS GESTATION OR EARLIER - COMPARISONWITH 1ST-TRIMESTER TRANSABDOMINAL CHORIONIC VILLUS SAMPLING, Obstetrics and gynecology, 83(4), 1994, pp. 543-548
Objective: To compare our initial experiences with early amniocentesis
and transabdominal chorionic villus sampling (CVS). Methods: We compa
red the diagnostic and pregnancy outcomes of our initial 250 patients
undergoing early amniocentesis (at or before the 14th completed week o
f gestation) or transabdominal CVS (performed between 9.5-12.9 weeks'
gestation). In both groups, the indication for prenatal diagnosis was
advanced maternal age (35 years or older at estimated date of delivery
). Results: No diagnostic errors were made using either technique, and
the culture failure rate for both methods was 0.8% (two of 250). Seve
n cytogenetic abnormalities in the early amniocentesis group and seven
in the transabdominal CVS group were detected. Nine of the 250 women
undergoing early amniocentesis reported spontaneous miscarriages follo
wing the procedure, compared to five in the transabdominal CVS group.
The loss rates were 3.8% in the early amniocentesis group and 2.1% in
the transabdominal CVS group among continuing pregnancies. Frequencies
of premature delivery, small for gestational age infants, and associa
ted structural defects in both groups were comparable. Conclusions: At
this time, early amniocentesis cannot be assumed to be equal to conve
ntional transabdominal CVS or amniocentesis with regard to safety or a
ccuracy; only a large cohort randomized study will adequately determin
e the safety and efficacy of early amniocentesis.