Introduction: Introduction: To estimate the procedure-related risks of pregnancy loss following chorionic villus sampling (CVS) and amniocentesis (AC) compared to pregnancies without procedure.
Methods: This cohort study enrolled all women who underwent CVS or AC at the Department of Perinatology, University Medical Centre, Ljubljana, Slovenia (from January 2013 to June 2015). For each group we obtained a maternal age and gestational age (11-14 weeks for CVS and >15 weeks for AC) for a matched control group without invasive procedures from the national database. The data was obtained from hospital records and telephone surveys concerning pregnancy outcomes. Pregnancy loss rates in intervention vs. control groups were compared by generating relative risk (RR) with a 95% confidence interval.
Results: During the study period, 828 women underwent CVS and 2,164 women underwent AC. Complete outcome data was available in 2,798 cases (93.5%, 770 CVS, 2,028 AC). Pregnancy loss occurred in 8/770 (1.04%, 95% CI 0.4-2.0%) after CVS vs. 15/1130 (1.33%, 95% CI 0.8-2.2%) in matched control (RR 0.8, 95% CI 0.33-1.8, p=0.6). It occurred in 16/2028 (0.79%, 95% CI 0.5-1.3%) after AC vs. 14/395 (3.29%, 95% CI 2.1-5.8%) in matched control (RR 0.2, 95% CI 0.11-0.45, p<0.0001).
Conclusion: The pregnancy loss rates after CVS and AC were comparable to losses in pregnancies without these procedures. With the increasing use of non-invasive prenatal testing, information that the invasive procedures are safe when indicated is essential.
Uvod: Namen raziskave je bil oceniti tveganje za zaplete po biopsiji horionskih resic (CVS) in amniocentezi (AC) ter ga primerjati z zapleti v nosečnostih brez tega posega.
Metode: V kohortno študijo smo vključili vse nosečnice, ki so imele CVS ali AC na Kliničnem oddelku za perinatologijo univerzitetnega kliničnega centra v Ljubljani med januarjem 2013 in junijem 2015. Skupini nosečnic po CVS in AC smo primerjali s skupinami nosečnic iz nacionalne podatkovne baze nosečnic brez invazivnega posega in je bila primerljiva v maternalni in gestacijski starosti (11–14 tednov za CVS in > 15 tednov za AC). Podatke za skupini po CVS in AC smo pridobili iz bolnišnične dokumentacije in preko telefonskega pogovora o izidu nosečnosti. Pogostost neuspele nosečnosti smo primerjali s kontrolno skupino z uporabo relativnega tveganja (RR) in s 95-odstotnim konfidenčnim intervalom.
Rezultati: Vključili smo 828 nosečnic po CVS in 2.164 nosečnic po AC. Vključili smo 2798 (93,5 %, 7 70 po CVS, 2028 po AC) primerov, za katere smo pridobili popolne podatke o izidu nosečnosti. Do zapletov je prišlo v 8 od 770 primerov po CVS (1,04 %, 95 % CI 0,4–2,0 %) in v 15 od 1130 primerov (1,33 %, 95 % CI 0,8–2,2 %) v primerljivi skupini brez invazivnega posega (RR 0,8, 95 %, CI 0,33–1,8, p = 0,6). Do zapletov je prišlo v 16 od 2.028 primerih po AC (0,79 %, 95 % CI 0,5–1,3 %) in v 14 od 395 primerih v primerjavi s primerljivo skupino brez invazivnega posega, (3,29 %, 95 % CI 2,1–5,8 %) (RR 0,2, 95 % CI 0,11–0,45, p < 0,0001).
Zaključek: Pogostost zapletov po CVS in AC je bila primerljiva s številom zapletov v nosečnostih brez invazivnega posega. Z naraščanjem uporabe neinvazivnih predrojstnih testov je informacija pri svetovanju pacientkam pred invazivnimi posegi, da so ti varni ob ustrezni indikaciji, ključna.
Keywords: amniocentesis; chorionic villus sampling; pregnancy loss; prenatal diagnosis.
© 2021 Ivana Paljk Likar, Ksenija Slavec Jere, Teja Možina, Ivan Verdenik, Nataša Tul, published by Sciendo.