title: A comparison of pregnancy loss between transcervical and transabdominal chorionic villus sampling.
abstract: OBJECTIVE
  To evaluate the comparative safety of transcervical and transabdominal chorionic villus sampling (CVS).
  
  
  METHODS
  From May 1988 to January 1992, CVS was performed by two operators at 9-12 weeks' gestation in 1048 singleton pregnancies. The sampling method for each patient, transabdominal or transcervical, was chosen primarily based upon placental location; the transabdominal route was used for anterior or fundal location and the transcervical route for posterior placentation. Perinatal outcome was assessed by post-procedure patient telephone contact, mid-gestation ultrasound evaluation, postpartum questionnaire completed by the referring obstetrician, and telephone interview with each patient after delivery.
  
  
  RESULTS
  Complete follow-up was available in 1012 cases (97%). Excluding 39 elective abortions, 35 of 973 euploid pregnancies aborted spontaneously. The difference in fetal loss rate between transcervical and transabdominal CVS approached statistical significance (5.2 versus 2.9%; P = .058). Bleeding before CVS (P = .006) and multiple placental aspirations (P = .022) were associated with fetal loss for the entire study group. An interaction between uterine position and sampling method was also indicated; an increased loss rate was associated with transcervical CVS in the presence of uterine retroversion (P = .0017).
  
  
  CONCLUSIONS
  Despite choosing the preferred CVS method for each patient, an increased loss rate may be associated with transcervical sampling in the presence of uterine retroversion.
authors.affiliation: Division of Maternal-Fetal Medicine, Evanston Hospital, Illinois.
authors.forename: R K
authors.initials: RK
authors.lastname: Silver
authors.forename: S N
authors.initials: SN
authors.lastname: MacGregor
authors.forename: L H
authors.initials: LH
authors.lastname: Muhlbach
authors.forename: M P
authors.initials: MP
authors.lastname: Kambich
authors.forename: A
authors.initials: A
authors.lastname: Ragin
mesh_terms: D000005:Abdomen; D000022:Abortion, Spontaneous / Q000453:epidemiology / Q000209:etiology*; D000328:Adult; D002584:Cervix Uteri; D015193:Chorionic Villi Sampling / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D007752:Obstetric Labor, Premature / Q000453:epidemiology / Q000209:etiology*; D016017:Odds Ratio; D011247:Pregnancy; D012307:Risk Factors