CHORIONIC VILLUS SAMPLING UTILIZATION FOLLOWING REPORTS OF A POSSIBLEASSOCIATION WITH FETAL LIMB DEFECTS

Prenatal diagnosis choices were reviewed in 473 women who presented fo r genetic counselling prior to 11 weeks' gestation for the indication of advanced maternal age. Group A consisted of 336 patients who were u naware of a possible association between chorionic villus sampling (CV S) and limb defects. Group B consisted of 137 patients who were provid ed this information. Fifty-one per cent of patients in group A and 45 per cent of patients in group B chose CVS. This difference was not sig nificant by chi2 analysis (P = 0.7). Patterns of prenatal diagnosis pr ocedure utilization from 1987 to 1992 revealed a significant reduction in CVS utilization accompanied by a corresponding increase in amnioce ntesis after the association between CVS and limb defects was publiciz ed. Referrals for CVS counselling also significantly declined. However , acceptance rates did not change for those patients who received gene tic counselling. First-trimester genetic counselling, including a disc ussion regarding a possible association between CVS and limb defects, helps patients make informed decisions concerning prenatal diagnosis o ptions, and, in our population, resulted in no change in CVS acceptanc e rates.