A randomised controlled trial of biopsy forceps and cannula aspiration for transcervical chorionic villus sampling.
OBJECTIVE
This trial compared two instruments for transcervical chorionic villus sampling (CVS).


METHODS
Randomised controlled trial.


METHODS
Regional university prenatal diagnosis and treatment centre.


METHODS
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.


METHODS



METHODS
the rise in maternal serum alpha-fetoprotein (alpha-FP).


RESULTS
(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 alpha-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.
von Dadelszen
Peter
P
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada.
Sermer
Mathew
M
Hillier
Joan
J
Allen
Lynn C
LC
Fernandes
Bernie J J
BJ
Johnson
Jo-Ann M
JA
Shime
Jerry
J
Winsor
Elizabeth J T
EJ
Ryan
Greg
G
D001707:Biopsy, Needle / Q000295:instrumentation* / Q000379:methods / Q000592:standards; D002404:Catheterization / Q000592:standards*; D015193:Chorionic Villi Sampling / Q000295:instrumentation* / Q000379:methods / Q000592:standards; D020732:Cytogenetic Analysis; D004867:Equipment Design; D005260:Female; D005331:Fetomaternal Transfusion / Q000209:etiology; D006801:Humans; D009772:Obstetrical Forceps; D017060:Patient Satisfaction; D011247:Pregnancy; D011256:Pregnancy Outcome; D013525:Surgical Instruments / Q000592:standards*; D000509:alpha-Fetoproteins / Q000378:metabolism
D000509:alpha-Fetoproteins