Donald School Journal of Ultrasound in Obstetrics and Gynecology

Register      Login

VOLUME 18 , ISSUE 1 ( January-March, 2024 ) > List of Articles

REVIEW ARTICLE

Chorionic Villus Sampling

Ulla Marton, Asim Kurjak, Milan Stanojevic

Keywords : Amniocentesis, Aneuploidy, Chorionic villi sampling, Genetic counseling, Prenatal diagnosis, Ultrasound

Citation Information : Marton U, Kurjak A, Stanojevic M. Chorionic Villus Sampling. Donald School J Ultrasound Obstet Gynecol 2024; 18 (1):45-52.

DOI: 10.5005/jp-journals-10009-2005

License: CC BY-NC 4.0

Published Online: 28-03-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Rapid improvements in the field of prenatal medicine have been achieved due to the technological advancement of ultrasonography that has allowed recognition of various ultrasonographic findings and their combination with biochemical results and demographic characteristics in order to estimate a final individual risk for a chromosomal anomaly of the fetus and analysis of short fragments of fetal DNA released into the mother's bloodstream through a natural process of cell death. Invasive testing still remains the main clinically available diagnostic modality for the definite diagnosis of both chromosomal anomalies and many single-gene disorders. Amniocentesis is performed between 15 and 20 weeks of pregnancy to obtain fetal cells for genetic testing. This method is performed almost in the middle of pregnancy, and waiting for the results of the analysis may indicate termination of pregnancy in the second trimester. Chorionic villus sampling (CVS), usually performed between 11+0 and 13+6 weeks of gestation, is one of the invasive diagnostic methods used to diagnose chromosomal, genetic, and metabolic diseases in the embryonic period. Invasive procedures such as CVS and amniocentesis still remain the only definitive diagnostic tests for aneuploidy in pregnancy. CVS, as an invasive procedure carried out with experienced physicians in specialist centers, is not associated with a significant increase in fetal loss rate, with a risk rate below 0.5%, and the possible background risk for miscarriage is significantly higher in the presence of fetal anomaly and abnormal karyotype. Ultrasound-guided transabdominal (TA) CVS is a useful outdoor procedure and is considered the method of choice for fetal sampling and accurate early prenatal diagnosis.


PDF Share
  1. Khalil A, Akolekar R, Pandya P, et al. Chorionic villus sampling at 11 to 13 weeks of gestation and hypertensive disorders in pregnancy. Obstet Gynecol 2010;116(2 Pt 1):374–380. DOI: 10.1097/AOG.0b013e3181e7ce75
  2. Navaratnam K, Alfirevic Z, Royal College of Obstetricians and Gynaecologists. Amniocentesis and chorionic villus sampling: green-top guideline No. 8 July 2021: green-top guideline No. 8. BJOG 2022;129(1):e1–e15. DOI: 10.1111/1471-0528.16821
  3. ACOG. Prenatal diagnostic testing for genetic disorders. https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2016/05/prenatal-diagnostic-testing-for-genetic-disorders
  4. Floridia M, Masuelli G, Meloni A, et al. Amniocentesis and chorionic villus sampling in HIV-infected pregnant women: a multicentre case series. BJOG 2017;124(8):1218–1223. DOI: 10.1111/1471-0528.14183
  5. Nicolaides KH. First-trimester screening for chromosomal abnormalities. Semin Perinatol 2005;29(4):190–194. DOI: 10.1053/j.semperi.2005.06.001
  6. Evans MI, Goldberg JD, Horenstein J, et al. Selective termination for structural, chromosomal, and mendelian anomalies: international experience. Am J Obstet Gynecol 1999;181(4):893–897. DOI: 10.1016/s0002-9378(99)70321-2
  7. Ahmed S. Transabdominal chorionic villus sampling (CVS) for prenatal diagnosis of genetic disorders. J Coll Physicians Surg Pak 2006;16(3):204–207.
  8. Alfirevic Z, Navaratnam K, Mujezinovic F. Amniocentesis and chorionic villus sampling for prenatal diagnosis. Cochrane Database Syst Rev 2017;9(9):CD003252. DOI: 10.1002/14651858.CD003252.pub2
  9. Jackson LG, Wapner RJ. Risks of chorion villus sampling. Baillieres Clin Obstet Gynaecol 1987;1(3):513–531. DOI: 10.1016/s0950-3552(87)80004-4
  10. Medical Research Council European trial of chorion villus sampling. MRC working party on the evaluation of chorion villus sampling. Lancet 1991;337(8756):1491–1499.
  11. Brambati B, Oldrini A, Ferrazzi E, et al. Chorionic villus sampling: an analysis of the obstetric experience of 1,000 cases. Prenat Diagn 1987;7(3):157–169. DOI: 10.1002/pd.1970070303
  12. Multicentre randomised clinical trial of chorion villus sampling and amniocentesis. First report. Canadian Collaborative CVS-Amniocentesis Clinical Trial Group. Lancet 1989;1(8628):1–6.
  13. Rhoads GG, Jackson LG, Schlesselman SE, et al. The safety and efficacy of chorionic villus sampling for early prenatal diagnosis of cytogenetic abnormalities. N Engl J Med 1989;320(10):609–617. DOI: 10.1056/NEJM198903093201001
  14. Saura R, Gauthier B, Taine L, et al. Operator experience and fetal loss rate in transabdominal CVS. Prenat Diagn 1994;14(1):70–71. DOI: 10.1002/pd.1970140115
  15. Kuliev A, Jackson L, Froster U, et al. Chorionic villus sampling safety. Report of World Health Organization/EURO meeting in association with the Seventh International Conference on Early Prenatal Diagnosis of Genetic Diseases, Tel-Aviv, Israel, May 21, 1994. Am J Obstet Gynecol 1996;174(3):807–811. DOI: 10.1016/s0002-9378(96)70304-6
  16. Cederholm M, Axelsson O. A prospective comparative study on transabdominal chorionic villus sampling and amniocentesis performed at 10-13 week's gestation. Prenat Diagn 1997;17(4):311–317. DOI: 10.1002/(sici)1097-0223(199704)17:4< 311::aid-pd 53 > 3.0.co;2-i
  17. Smidt-Jensen S, Permin M, Philip J. Sampling success and risk by transabdominal chorionic villus sampling, transcervical chorionic villus sampling and amniocentesis: a randomized study. Ultrasound Obstet Gynecol 1991;1(2):86–90. DOI: 10.1046/j.1469-0705.1991.01020086.x
  18. Mujezinovic F, Alfirevic Z. Procedure-related complications of amniocentesis and chorionic villous sampling: a systematic review. Obstet Gynecol 2007;110(3):687–694. DOI: 10.1097/01.AOG.0000278820.54029.e3
  19. Akolekar R, Bower S, Flack N, et al. Prediction of miscarriage and stillbirth at 11-13 weeks and the contribution of chorionic villus sampling. Prenat Diagn 2011;31(1):38–45. DOI: 10.1002/pd.2644
  20. Spencer K, Cowans NJ, Avgidou K, et al. First-trimester ultrasound and biochemical markers of aneuploidy and the prediction of impending fetal death. Ultrasound Obstet Gynecol 2006;28(5):637–643. DOI: 10.1002/uog.3809
  21. Sebire NJ, Snijders RJ, Hughes K, et al. Screening for trisomy 21 in twin pregnancies by maternal age and fetal nuchal translucency thickness at 10-14 weeks of gestation. Br J Obstet Gynaecol 1996;103(10):999–1003. DOI: 10.1111/j.1471-0528.1996.tb09550.x
  22. Wapner RJ, Johnson A, Davis G. Prenatal diagnosis in twin gestations: a comparison between second trimester amniocentesis and first trimester chorionic villus sampling. Obstet Gynecol 1993;82(1):49–56.
  23. Gil MM, Rodríguez-Fernández M, Elger T, et al. Risk of fetal loss after chorionic villus sampling in twin pregnancy derived from propensity score matching analysis. Ultrasound Obstet Gynecol 2022;59(2):162–168. DOI: 10.1002/uog.24826
  24. Elger T, Akolekar R, Syngelaki A, et al. Fetal loss after chorionic villus sampling in twin pregnancy. Ultrasound Obstet Gynecol 2021;58(1):48–55. DOI: 10.1002/uog.23694
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.