COMPARISON OF PREGNANCY LOSS BETWEEN TRANSCERVICAL AND TRANSABDOMINALCHORIONIC VILLUS SAMPLING

Objective: To evaluate the comparative safety of transcervical and tra nsabdominal chorionic villus sampling (CVS). Methods: From May 1988 to January 1992, CVS was performed by two operators at 9-12 weeks' gesta tion in 1048 singleton pregnancies. The sampling method for each patie nt, transabdominal or transcervical, was Chosen primarily based upon p lacental location; the transabdominal route was used for anterior or f undal location and the transcervical route for posterior placentation. Perinatal outcome was assessed by post-procedure patient telephone co ntact, midgestation ultrasound evaluation, postpartum questionnaire co mpleted by the referring obstetrician, and telephone interview with ea ch patient after delivery. Results: Complete follow-up was available i n 1012 cases (97%). Excluding 39 elective abortions, 35 of 973 euploid pregnancies aborted spontaneously. The difference in fetal loss rate between transcervical and transabdominal CVS approached statistical si gnificance (5.2 versus 2.9%; P = .058). Bleeding before CVS (P = .006) and multiple placental aspirations (P = .022) were associated with fe tal loss for the entire study group. An interaction between uterine po sition and sampling method was also indicated; an increased loss rate was associated with transcervical CVS in the presence of uterine retro version (P = .0017). Conclusion: Despite choosing the preferred CVS me thod for each patient, an increased loss rate may be associated with t ranscervical sampling in the presence of uterine retroversion.