Journal Mobile Options
Table of Contents
Vol. 27, No. 1, 2010
Issue release date: January 2010
Section title: Mini-Review
Free Access
Fetal Diagn Ther 2010;27:1–7
(DOI:10.1159/000271995)

Update on Procedure-Related Risks for Prenatal Diagnosis Techniques

Tabor A.a · Alfirevic Z.b
aDepartment of Fetal Medicine, Copenhagen University Hospital Rigshospitalet and Faculty of Health Sciences, Copenhagen, Denmark; bDivision of Perinatal and Reproductive Medicine, University of Liverpool, Liverpool Women’s Hospital, Liverpool, UK
email Corresponding Author

Abstract

Introduction: As a consequence of the introduction of effective screening methods, the number of invasive prenatal diagnostic procedures is steadily declining. The aim of this review is to summarize the risks related to these procedures. Material and Methods: Review of the literature. Results: Data from randomised controlled trials as well as from systematic reviews and a large national registry study are consistent with a procedure-related miscarriage rate of 0.5–1.0% for amniocentesis as well as for chorionic villus sampling (CVS). In single-center studies performance may be remarkably good due to very skilled operators, but these figures cannot be used for general counselling. Amniocentesis performed prior to 15 weeks had a significantly higher miscarriage rate than CVS and mid-trimester amniocentesis, and also increased the risk of talipes equinovarus. Amniocentesis should therefore not be performed before 15 + 0 weeks’ gestation. CVS on the other hand should not be performed before 10 weeks’ gestation due to a possible increase in risk of limb reduction defects. Discussion: Experienced operators have a higher success rate and a lower complication rate. The decreasing number of prenatal invasive procedures calls for quality assurance and monitoring of operators’ performance.

© 2009 S. Karger AG, Basel


  

Key Words

  • Amniocentesis
  • Chorionic villus sampling
  • Fetal loss
  • Prenatal diagnosis

References

  1. Jacobson CB, Barter RH: Intrauterine diagnosis and management of genetic defects. Am J Obstet Gynecol 1967;99:796–805.
  2. Boyd PA, DeVigan C, Khoshnood B, Loane M, Garne E, Dolk H, EUROCAT Working Group: Survey of prenatal screening policies in Europe for structural malformations and chromosome anomalies, and their impact on detection and termination rates for neural tube defects and Down’s syndrome. BJOG 2008;115:689–696.
  3. Ekelund CK, Jørgensen FS, Petersen OB, Sundberg K, Tabor A, Danish Fetal Medicine Research Group: Impact of a new national screening policy for Down’s syndrome in Denmark; a population based cohort study. BMJ 2008;337:a2547.
  4. Nicolaides KH: First-trimester screening for chromosomal abnormalities. Semin Perinatol 2005;29:190–194.
  5. Zaragoza E, Akolekar R, Poon LC, Pepes S, Nicolaides KH: Maternal serum placental growth factor at 11–13 weeks in chromosomally abnormal pregnancies. Ultrasound Obstet Gynecol 2009;33:382–386.
  6. Evans MI, Goldberg JD, Horenstein J, Wapner RJ, Ayoub MA, Stone J, et al: Selective termination for structural, chromosomal, and Mendelian anomalies: international experience. Am J Obstet Gynecol 1999;181:893–897.
  7. Hoesli IM, Walter-Goebel I, Tercanli S, Holzgreve W: Spontaneous fetal loss rates in a non-selected population. Am J Med Genet 2001;100:106–109.
  8. Tabor A, Madsen M, Obel E, Philip J, Bang J, Norgaard-Pedersen B: Randomised controlled trial of genetic amniocentesis in 4606 low-risk women. Lancet 1986;i:1287–1293.
  9. Caughey AB, Hopkins LM, Norton ME: Chorionic villus sampling compared with amniocentesis and the difference in the rate of pregnancy loss. Obstet Gynecol 2006;108:612–616.
  10. Odibo AO, Gray DL, Dicke JM, Stamilio DM, Macones GA, Crane JP: Revisiting the fetal loss rate after second-trimester genetic amniocentesis: a single center’s 16-year experience. Obstet Gynecol 2008;111:589–595.
  11. Tongsong T, Wanapirak C, Sirivatanapa P, Piyamongkol W, Sirichotiyakul S, Yampochai A: Amniocentesis-related fetal loss: a cohort study. Obstet Gynecol 1998;92:64–67.
  12. Eddleman KA, Malone FD, Sullivan L, Dukes K, Berkowitz RL, Kharbutli Y, Porter TF, Luthy DA, Dugoff L, Craigo SD, Timor-Tritsch IE, Carr SR, Wolfe HM, D’Alton ME: Pregnancy loss rates after midtrimester amniocentesis. Obstet Gynecol 2006;108:1067–1072.
  13. Mujezinovic F, Alfirevic Z: Procedure-related complications of amniocentesis and chorionic villus sampling. Obstet Gynecol 2007;110:687–694.
  14. Canadian Collaborative CVS-Amniocentesis Clinical Trial Group: Multicentre randomised clinical trial of chorionic villus sampling and amniocentesis. Lancet 1989;i:1–6.
  15. Rhoads GG, Jackson LG, Schesselman SA, de la Cruz FF, Desnick RJ, Golbus MS, Ledbetter DH, Lubs HA, Mahoney MJ, Pergament E: The safety and efficacy of chorionic villus sampling for early prenatal diagnosis of cytogenetic abnormalities. N Engl J Med 1989;320:610–617.

    External Resources

  16. MRC Working Party in the Evaluation of Chorion Villus Sampling: Medical Research Council European Trial of chorion villus sampling. Lancet 1991;337:1491–1499.
  17. Alfirevic Z, Mujezinovic F, Sundberg K, Brigham S: Amniocentesis and chorionic villus sampling for prenatal diagnosis. Cochrane Database System Rev 2003;issue 3, Art No CD003252.
  18. Nicolaides K, Brizot M de L, Patel F, Snijders R: Comparison of chorionic villus sampling and amniocentesis for fetal karyotyping at 10–13 weeks’ gestation. Lancet 1994;344:435–439.
  19. Canadian Early and Mid-trimester Amniocentesis Trial (CEMAT) Group: Randomised trial to assess safety and fetal outcome of early and midtrimester amniocentesis. Lancet 1998;351:242–247.
  20. Muller F, Thibaud D, Poloce F, Gelineau MC, Bernard M, Brochet C, Millet C, Réal JY, Dommergues M: Risk of amniocentesis in women screened positive for Down syndrome with second trimester maternal serum markers. Prenat Diagn 2002;22:1036–1039.
  21. Tabor A, Vestergaard CHF, Lidegaard Ø: Fetal loss rate after chorionic villus sampling and amniocentesis: an 11-year national registry study. Ultrasound Obstet Gynecol 2009;34:19–24.
  22. Odibo AO, Dicke JM, Gray DL, Oberle B, Stamilio DM, Macones GA, Crane JP: Evaluating the rate and risk factors for fetal loss after chorionic villus sampling. Obstet Gynecol 2008;112:813–819.
  23. Sperling L, Kiil C, Larsen LU, Qvist I, Schwartz M, Jørgensen C, Skajaa K, Bang J, Tabor A: Naturally conceived twins with monochorionic placentation have the highest risk of fetal loss. Ultrasound Obstet Gynecol 2006;28:644–652.
  24. Cahill AG, Macones GA, Stamilio DM, Dicke JM, Crane JP, Odibo AO: Pregnancy loss rate after mid-trimester amniocentesis in twin pregnancies. Am J Obstet Gynecol 2009;200:257.e1–257.e6.

    External Resources

  25. Yukobowich E, Anteby EY, Cohen SM, Lavy Y, Granat M, Yagel S: Risk of fetal loss in twin pregnancies undergoing second trimester amniocentesis. Obstet Gynecol 2001;98:231–234.
  26. Jenkins TM, Wapner RJ: The challenge of prenatal diagnosis in twin pregnancies. Curr Opin Obstet Gynecol 2000;12:87–92.
  27. Millaire M, Bujold E, Morency A-M, Gauthier RJ: Mid-trimester genetic amniocentesis in twin pregnancy and the risk of fetal loss. J Obstet Gynaecol Can 2006;28:512–518.

    External Resources

  28. Sundberg K, Bang J, Smidt-Jensen S, Brocks V, Lundsteen C, Parner J, Philip J: Randomised study of the risk of fetal loss related to early amniocentesis versus chorionic villus sampling. Lancet 1997;350:697–703.
  29. Philip J, Silver RK, Wilson RD, Thom EA, Zachary JM, Mohide P, Mahoney MJ, Simpson JL, Platt LD, Pergament E, Hershey D, Filkins K, Johnson A, Shulman LP, Bang J, MacGregor S, Smith JR, Shaw D, Wapner RJ, Jackson LG: Late first-trimester invasive prenatal diagnosis: results of an international randomized trial. Obstet Gynecol 2004;103:1164–1173.
  30. Smidt-Jensen S, Permin M, Philip J, Lundsteen C, Zachary JM, Fowler SE, Grüning K: Randomised comparison of amniocentesis and transabdominal and transcervical chorionic villus sampling. Lancet 1992;340:1237–1244.
  31. Cederholm M, Haglund B, Axelsson O: Infant morbidity following amniocentesis and chorionic villus sampling for prenatal karyotyping. BJOG 2005;112:394–402.
  32. Firth HV, Boyd PA, Chamberlain P: Severe limb abnormalities after chorion villus sampling at 56–66 days of gestation. Lancet 1991;337:762–763.
  33. Froster UG, Jackson L: Limb defects and chorionic villus sampling: results from an international registry, 1992–1994. Lancet 1996;347:489–494.
  34. Grobman WA, Auger M, Shulman LP, Elias S: The association between chorionic villus sampling and preeclampsia. Prenat Diagn 2009;29:800–803.
  35. Hislop A, Fairweather DVI: Amniocentesis and lung growth: an animal experiment with clinical implications. Lancet 1982;ii:1271–1272.

    External Resources

  36. Baird PA, Yee IM, Sadovnik AD: Population-based study of long-term outcomes after amniocentesis. Lancet 1994;344:1134–1136.
  37. Finegan JA, Sitarenios G, Bolan PL, Sarabura AD: Children whose mothers had second trimester amniocentesis: follow up at school age. Br J Obstet Gynaecol 1996;103:214–218.
  38. Schaap AHP, van der Pol HG, Boer K, Leschot NJ, Wolf H: Long-term follow-up of infants after transcervical chorionic villus sampling and after amniocentesis to compare congenital abnormalities and health status. Prenat Diagn 2002;22:598–604.
  39. Gosden C, Tabor A, Leck I, Grant A, Alfirevic Z, Wald N: Amniocentesis and chorionic villus sampling; in Wald N, Leck I (eds): Antenatal and Neonatal Screening. London, Oxford University Press, 2000, pp 470–517.
  40. Eisenberg B, Wapner RJ: Clinical procedures in prenatal diagnosis. Clin Obstet Gynecol 2002;16:611–627.
  41. Ledbetter DH, Martin AO, Verlinsky Y, Pergament E, Jackson L, Yang-Feng T, Schonberg SA, Gilbert F, Zachary JM, Barr M: Cytogenetic results of chorionic villus sampling: high success rate and diagnostic accuracy in the United States collaborative study. Am J Obstet Gynecol 1990;162:495–501.
  42. NICHD National Registry for amniocentesis study group: midtrimester amniocentesis for prenatal diagnosis: safety and accuracy. JAMA 1976;236:1471–1476.

    External Resources

  43. Marthin T, Liedgren S, Hammar M: Transplacental needle passage and other risk-factors associated with second trimester amniocentesis. Acta Obstet Gynecol Scand 1997;76:728–732.
  44. Athanasiadis AP, Pantazis K, Goulis DG, Vaitsi V, Assimakopoulos E, Tzevelekis F, Tsalikis T, Bontis JN: Comparison between 20G and 22G needle for second trimester amniocentesis in terms of technical aspects and short-term complications. Prenat Diagn 2009;29:761–765.
  45. Müngen E, Tütüncü L, Muhcu M, Yergök YZ: Pregnancy outcome following second-trimester amniocentesis: a case-control study. Am J Perinatology 2006;23:25–30.
  46. Giorlandino C, Cignini P, Cini M, Brizzi C, Carcioppolo O, Milite V, Coco C, Gentili P, Mangiafico L, Mesoraca A, Bizzoco D, Gabrielli I, Mobili L: Antibiotic prophylaxis before second-trimester genetic amniocentesis (APGA): a single-centre open randomised controlled trial. Prenat Diagn 2009;29:6–12.
  47. Nizard J, Dumez M, Ville Y: Teaching ultrasound-guided invasive procedures in fetal medicine: learning curves with and without an electronic guidance system. Ultrasound Obstet Gynecol 2002;19:274–277.
  48. Carlin AJ, Alfirevic Z: Techniques for chorionic villus sampling and amniocentesis: a survey of practice in specialist UK centres. Prenat Diagn 2008;28:914–919.
  49. van den Berg C, Braat AP, Van Opstal D, Halley DJ, Kleijer WJ, den Hollander NS, Brandenburg H, Pijpers L, Los FJ: Amniocentesis or chorionic villus sampling in multiple gestations? Experience with 500 cases. Prenat Diagn 1999;19:234–244.
  50. Silver RK, Russell TL, Kambich MP, Leeth EA, MacGregor SN, Sholl JS: Midtrimester amniocentesis: influence of operator caseload on sampling efficiency. J Reprod Med 1998;43:191–195.
  51. Wijnberger LDE, Schouw YT van der, Christiaens GCML: Learning in medicine: chorionic villus sampling. Prenat Diagn 2000;20:241–246.
  52. Ville Y, Cooper M, Revel A, Frydman R, Nicolaides KH: Development of a training model for ultrasound-guided invasive procedures in fetal medicine. Ultrasound Obstet Gynecol 1995;5:180–183.
  53. Alfirevic Z: Who should be allowed to perform amniocentesis and chorionic villus sampling? Ultrasound Obstet Gynecol 2009;34:12–13.
  54. The Danish National Board of Health: Report from a working commission ‘Prenatal diagnosis and risk assessment’ http://www.sst.dk/upload/fosterdiagnostik1_001.pdf. Copenhagen, 2003.
  55. Nanal R, Kyle P, Soothhill PW: A classification of pregnancy losses after invasive prenatal diagnostic procedures: an approach to allow comparison of units with a different case mix. Prenat Diagn 2003;23:488–492.

  

Author Contacts

Ann Tabor
Department of Fetal Medicine, Copenhagen University Hospital Rigshospitalet
Blegdamsvej 9
DK–2100 Copenhagen (Denmark)
Tel. +45 3545 0610, Fax +45 3545 4749, E-Mail ann.tabor@rh.regionh.dk

  

Article Information

Received: November 2, 2009
Accepted after revision: November 13, 2009
Published online: December 24, 2009
Number of Print Pages : 7
Number of Figures : 0, Number of Tables : 1, Number of References : 55

  

Publication Details

Fetal Diagnosis and Therapy (Clinical Advances and Basic Research)

Vol. 27, No. 1, Year 2010 (Cover Date: January 2010)

Journal Editor: Gratacós E. (Barcelona)
ISSN: 1015-3837 (Print), eISSN: 1421-9964 (Online)

For additional information: http://www.karger.com/FDT


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Abstract

Introduction: As a consequence of the introduction of effective screening methods, the number of invasive prenatal diagnostic procedures is steadily declining. The aim of this review is to summarize the risks related to these procedures. Material and Methods: Review of the literature. Results: Data from randomised controlled trials as well as from systematic reviews and a large national registry study are consistent with a procedure-related miscarriage rate of 0.5–1.0% for amniocentesis as well as for chorionic villus sampling (CVS). In single-center studies performance may be remarkably good due to very skilled operators, but these figures cannot be used for general counselling. Amniocentesis performed prior to 15 weeks had a significantly higher miscarriage rate than CVS and mid-trimester amniocentesis, and also increased the risk of talipes equinovarus. Amniocentesis should therefore not be performed before 15 + 0 weeks’ gestation. CVS on the other hand should not be performed before 10 weeks’ gestation due to a possible increase in risk of limb reduction defects. Discussion: Experienced operators have a higher success rate and a lower complication rate. The decreasing number of prenatal invasive procedures calls for quality assurance and monitoring of operators’ performance.

© 2009 S. Karger AG, Basel


  

Author Contacts

Ann Tabor
Department of Fetal Medicine, Copenhagen University Hospital Rigshospitalet
Blegdamsvej 9
DK–2100 Copenhagen (Denmark)
Tel. +45 3545 0610, Fax +45 3545 4749, E-Mail ann.tabor@rh.regionh.dk

  

Article Information

Received: November 2, 2009
Accepted after revision: November 13, 2009
Published online: December 24, 2009
Number of Print Pages : 7
Number of Figures : 0, Number of Tables : 1, Number of References : 55

  

Publication Details

Fetal Diagnosis and Therapy (Clinical Advances and Basic Research)

Vol. 27, No. 1, Year 2010 (Cover Date: January 2010)

Journal Editor: Gratacós E. (Barcelona)
ISSN: 1015-3837 (Print), eISSN: 1421-9964 (Online)

For additional information: http://www.karger.com/FDT


Article / Publication Details

First-Page Preview
Abstract of Mini-Review

Received: 11/2/2009
Accepted: 11/13/2009
Published online: 12/24/2009
Issue release date: January 2010

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 1

ISSN: 1015-3837 (Print)
eISSN: 1421-9964 (Online)

For additional information: http://www.karger.com/FDT


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Jacobson CB, Barter RH: Intrauterine diagnosis and management of genetic defects. Am J Obstet Gynecol 1967;99:796–805.
  2. Boyd PA, DeVigan C, Khoshnood B, Loane M, Garne E, Dolk H, EUROCAT Working Group: Survey of prenatal screening policies in Europe for structural malformations and chromosome anomalies, and their impact on detection and termination rates for neural tube defects and Down’s syndrome. BJOG 2008;115:689–696.
  3. Ekelund CK, Jørgensen FS, Petersen OB, Sundberg K, Tabor A, Danish Fetal Medicine Research Group: Impact of a new national screening policy for Down’s syndrome in Denmark; a population based cohort study. BMJ 2008;337:a2547.
  4. Nicolaides KH: First-trimester screening for chromosomal abnormalities. Semin Perinatol 2005;29:190–194.
  5. Zaragoza E, Akolekar R, Poon LC, Pepes S, Nicolaides KH: Maternal serum placental growth factor at 11–13 weeks in chromosomally abnormal pregnancies. Ultrasound Obstet Gynecol 2009;33:382–386.
  6. Evans MI, Goldberg JD, Horenstein J, Wapner RJ, Ayoub MA, Stone J, et al: Selective termination for structural, chromosomal, and Mendelian anomalies: international experience. Am J Obstet Gynecol 1999;181:893–897.
  7. Hoesli IM, Walter-Goebel I, Tercanli S, Holzgreve W: Spontaneous fetal loss rates in a non-selected population. Am J Med Genet 2001;100:106–109.
  8. Tabor A, Madsen M, Obel E, Philip J, Bang J, Norgaard-Pedersen B: Randomised controlled trial of genetic amniocentesis in 4606 low-risk women. Lancet 1986;i:1287–1293.
  9. Caughey AB, Hopkins LM, Norton ME: Chorionic villus sampling compared with amniocentesis and the difference in the rate of pregnancy loss. Obstet Gynecol 2006;108:612–616.
  10. Odibo AO, Gray DL, Dicke JM, Stamilio DM, Macones GA, Crane JP: Revisiting the fetal loss rate after second-trimester genetic amniocentesis: a single center’s 16-year experience. Obstet Gynecol 2008;111:589–595.
  11. Tongsong T, Wanapirak C, Sirivatanapa P, Piyamongkol W, Sirichotiyakul S, Yampochai A: Amniocentesis-related fetal loss: a cohort study. Obstet Gynecol 1998;92:64–67.
  12. Eddleman KA, Malone FD, Sullivan L, Dukes K, Berkowitz RL, Kharbutli Y, Porter TF, Luthy DA, Dugoff L, Craigo SD, Timor-Tritsch IE, Carr SR, Wolfe HM, D’Alton ME: Pregnancy loss rates after midtrimester amniocentesis. Obstet Gynecol 2006;108:1067–1072.
  13. Mujezinovic F, Alfirevic Z: Procedure-related complications of amniocentesis and chorionic villus sampling. Obstet Gynecol 2007;110:687–694.
  14. Canadian Collaborative CVS-Amniocentesis Clinical Trial Group: Multicentre randomised clinical trial of chorionic villus sampling and amniocentesis. Lancet 1989;i:1–6.
  15. Rhoads GG, Jackson LG, Schesselman SA, de la Cruz FF, Desnick RJ, Golbus MS, Ledbetter DH, Lubs HA, Mahoney MJ, Pergament E: The safety and efficacy of chorionic villus sampling for early prenatal diagnosis of cytogenetic abnormalities. N Engl J Med 1989;320:610–617.

    External Resources

  16. MRC Working Party in the Evaluation of Chorion Villus Sampling: Medical Research Council European Trial of chorion villus sampling. Lancet 1991;337:1491–1499.
  17. Alfirevic Z, Mujezinovic F, Sundberg K, Brigham S: Amniocentesis and chorionic villus sampling for prenatal diagnosis. Cochrane Database System Rev 2003;issue 3, Art No CD003252.
  18. Nicolaides K, Brizot M de L, Patel F, Snijders R: Comparison of chorionic villus sampling and amniocentesis for fetal karyotyping at 10–13 weeks’ gestation. Lancet 1994;344:435–439.
  19. Canadian Early and Mid-trimester Amniocentesis Trial (CEMAT) Group: Randomised trial to assess safety and fetal outcome of early and midtrimester amniocentesis. Lancet 1998;351:242–247.
  20. Muller F, Thibaud D, Poloce F, Gelineau MC, Bernard M, Brochet C, Millet C, Réal JY, Dommergues M: Risk of amniocentesis in women screened positive for Down syndrome with second trimester maternal serum markers. Prenat Diagn 2002;22:1036–1039.
  21. Tabor A, Vestergaard CHF, Lidegaard Ø: Fetal loss rate after chorionic villus sampling and amniocentesis: an 11-year national registry study. Ultrasound Obstet Gynecol 2009;34:19–24.
  22. Odibo AO, Dicke JM, Gray DL, Oberle B, Stamilio DM, Macones GA, Crane JP: Evaluating the rate and risk factors for fetal loss after chorionic villus sampling. Obstet Gynecol 2008;112:813–819.
  23. Sperling L, Kiil C, Larsen LU, Qvist I, Schwartz M, Jørgensen C, Skajaa K, Bang J, Tabor A: Naturally conceived twins with monochorionic placentation have the highest risk of fetal loss. Ultrasound Obstet Gynecol 2006;28:644–652.
  24. Cahill AG, Macones GA, Stamilio DM, Dicke JM, Crane JP, Odibo AO: Pregnancy loss rate after mid-trimester amniocentesis in twin pregnancies. Am J Obstet Gynecol 2009;200:257.e1–257.e6.

    External Resources

  25. Yukobowich E, Anteby EY, Cohen SM, Lavy Y, Granat M, Yagel S: Risk of fetal loss in twin pregnancies undergoing second trimester amniocentesis. Obstet Gynecol 2001;98:231–234.
  26. Jenkins TM, Wapner RJ: The challenge of prenatal diagnosis in twin pregnancies. Curr Opin Obstet Gynecol 2000;12:87–92.
  27. Millaire M, Bujold E, Morency A-M, Gauthier RJ: Mid-trimester genetic amniocentesis in twin pregnancy and the risk of fetal loss. J Obstet Gynaecol Can 2006;28:512–518.

    External Resources

  28. Sundberg K, Bang J, Smidt-Jensen S, Brocks V, Lundsteen C, Parner J, Philip J: Randomised study of the risk of fetal loss related to early amniocentesis versus chorionic villus sampling. Lancet 1997;350:697–703.
  29. Philip J, Silver RK, Wilson RD, Thom EA, Zachary JM, Mohide P, Mahoney MJ, Simpson JL, Platt LD, Pergament E, Hershey D, Filkins K, Johnson A, Shulman LP, Bang J, MacGregor S, Smith JR, Shaw D, Wapner RJ, Jackson LG: Late first-trimester invasive prenatal diagnosis: results of an international randomized trial. Obstet Gynecol 2004;103:1164–1173.
  30. Smidt-Jensen S, Permin M, Philip J, Lundsteen C, Zachary JM, Fowler SE, Grüning K: Randomised comparison of amniocentesis and transabdominal and transcervical chorionic villus sampling. Lancet 1992;340:1237–1244.
  31. Cederholm M, Haglund B, Axelsson O: Infant morbidity following amniocentesis and chorionic villus sampling for prenatal karyotyping. BJOG 2005;112:394–402.
  32. Firth HV, Boyd PA, Chamberlain P: Severe limb abnormalities after chorion villus sampling at 56–66 days of gestation. Lancet 1991;337:762–763.
  33. Froster UG, Jackson L: Limb defects and chorionic villus sampling: results from an international registry, 1992–1994. Lancet 1996;347:489–494.
  34. Grobman WA, Auger M, Shulman LP, Elias S: The association between chorionic villus sampling and preeclampsia. Prenat Diagn 2009;29:800–803.
  35. Hislop A, Fairweather DVI: Amniocentesis and lung growth: an animal experiment with clinical implications. Lancet 1982;ii:1271–1272.

    External Resources

  36. Baird PA, Yee IM, Sadovnik AD: Population-based study of long-term outcomes after amniocentesis. Lancet 1994;344:1134–1136.
  37. Finegan JA, Sitarenios G, Bolan PL, Sarabura AD: Children whose mothers had second trimester amniocentesis: follow up at school age. Br J Obstet Gynaecol 1996;103:214–218.
  38. Schaap AHP, van der Pol HG, Boer K, Leschot NJ, Wolf H: Long-term follow-up of infants after transcervical chorionic villus sampling and after amniocentesis to compare congenital abnormalities and health status. Prenat Diagn 2002;22:598–604.
  39. Gosden C, Tabor A, Leck I, Grant A, Alfirevic Z, Wald N: Amniocentesis and chorionic villus sampling; in Wald N, Leck I (eds): Antenatal and Neonatal Screening. London, Oxford University Press, 2000, pp 470–517.
  40. Eisenberg B, Wapner RJ: Clinical procedures in prenatal diagnosis. Clin Obstet Gynecol 2002;16:611–627.
  41. Ledbetter DH, Martin AO, Verlinsky Y, Pergament E, Jackson L, Yang-Feng T, Schonberg SA, Gilbert F, Zachary JM, Barr M: Cytogenetic results of chorionic villus sampling: high success rate and diagnostic accuracy in the United States collaborative study. Am J Obstet Gynecol 1990;162:495–501.
  42. NICHD National Registry for amniocentesis study group: midtrimester amniocentesis for prenatal diagnosis: safety and accuracy. JAMA 1976;236:1471–1476.

    External Resources

  43. Marthin T, Liedgren S, Hammar M: Transplacental needle passage and other risk-factors associated with second trimester amniocentesis. Acta Obstet Gynecol Scand 1997;76:728–732.
  44. Athanasiadis AP, Pantazis K, Goulis DG, Vaitsi V, Assimakopoulos E, Tzevelekis F, Tsalikis T, Bontis JN: Comparison between 20G and 22G needle for second trimester amniocentesis in terms of technical aspects and short-term complications. Prenat Diagn 2009;29:761–765.
  45. Müngen E, Tütüncü L, Muhcu M, Yergök YZ: Pregnancy outcome following second-trimester amniocentesis: a case-control study. Am J Perinatology 2006;23:25–30.
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