title: Second-trimester amniocentesis vs. chorionic villus sampling for prenatal diagnosis in multiple gestations.
abstract: OBJECTIVE
  To study the impact of invasive procedures for prenatal diagnosis on multiple pregnancies and compare first-trimester chorionic villus sampling with second-trimester amniocentesis.
  
  
  METHODS
  Retrospective study of 347 second-trimester amniocenteses and 69 chorionic villus sampling procedures.
  
  
  RESULTS
  Miscarriage occurred in 4.18% of women after amniocentesis and 4.54% of women after chorionic villus sampling. In the amniocentesis group the risk of miscarriage was higher in the cases with transplacental entry (4.54%) than in those with transamniotic entry (2.08%). The rates of preterm delivery < or = 32 weeks and preterm delivery < or = 35 weeks in the amniocentesis group were 11.8% and 32.4% and in the chorionic villus sampling group 16.66% and 23.8%, respectively. Total fetal loss rate was similar in the amniocentesis group (8.8%) and the chorionic villus sampling group (10.22%). In the 21 cases where selective feticide was carried out the total fetal loss rate was lower in the chorionic villus sampling group (8.3%) than in the amniocentesis group (11.1%), although the difference did not reach statistical significance.
  
  
  CONCLUSIONS
  Chorionic villus sampling appears to be a safe alternative to amniocentesis and should be considered as the method of choice particularly when there is a high risk of an affected fetus necessitating selective feticide.
authors.affiliation: First Department of Obstetrics and Gynecology, Alexandra Maternity Hospital, University of Athens, Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Antsaklis
authors.forename: A P
authors.initials: AP
authors.lastname: Souka
authors.forename: G
authors.initials: G
authors.lastname: Daskalakis
authors.forename: Y
authors.initials: Y
authors.lastname: Kavalakis
authors.forename: S
authors.initials: S
authors.lastname: Michalas
mesh_terms: D000028:Abortion, Induced; D000022:Abortion, Spontaneous / Q000209:etiology; D000328:Adult; D000649:Amniocentesis / Q000009:adverse effects*; D015193:Chorionic Villi Sampling / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D011272:Pregnancy, Multiple; D012307:Risk Factors; D017086:beta-Thalassemia / Q000175:diagnosis