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A randomised controlled trial of biopsy forceps and cannula aspiration for transcervical chorionic villus sampling
Author(s) -
Von Dadelszen Peter,
Sermer Mathew,
Hillier Joan,
Allen Lynn C.,
Fernandes Bernie J.J.,
Johnson JoAnn M.,
Shime Jerry,
Winsor Elizabeth J.T.,
Ryan Greg
Publication year - 2005
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2004.00483.x
Subject(s) - medicine , forceps , chorionic villus sampling , sampling (signal processing) , cannula , biopsy , vacuum aspiration , surgery , obstetrics , radiology , pregnancy , computer science , prenatal diagnosis , research methodology , population , fetus , environmental health , filter (signal processing) , biology , family planning , computer vision , genetics
Objective This trial compared two instruments for transcervical chorionic villus sampling (CVS). Design Randomised controlled trial. Setting Regional university prenatal diagnosis and treatment centre. Population Two hundred women were randomised at 10 +0 –12 +6 weeks of gestation to transcervical CVS using cannula aspiration (CA) or biopsy forceps (BF). Methods Women undergoing indicated CVS signed informed consent. Randomisation after decision to perform transcervical CVS. Main outcome measures Primary outcome: the rise in maternal serum α‐fetoprotein (α‐FP). Secondary outcomes: (i) placental trauma (fetomaternal haemorrhage [FMH]); (ii) laboratory, procedure, and cytogenetic results and pregnancy outcomes; (iii) patient and operator satisfaction; and (iv) economic analyses. Analyses were performed by intention to treat. Results The ‐FP rise did not differ between groups; there was no other evidence of placental trauma. BF were better tolerated by women, provided culturable tissue, after fewer instrument passes, with greater ease and in less time. BF were associated with cost savings. Conclusions Unlike ‐FP, other markers of FMH were unaltered, questioning the reliability of α‐FP as an indicator of FMH. Compared with CA, transcervical BF caused comparable placental trauma, appeared to be similarly effective and safe and were preferred by operators and patients.