Chorionic villus sampling and hemangiomas.
Chorionic villus sampling (CVS) is a widely used and safe method of prenatal diagnosis. In the 1990s, concerns were raised at several medical centers that there was an increased risk to the exposed fetus for the occurrence of limb deficiencies, hemangiomas, and other vascular disruption defects. The risk was greater when the procedure was performed earlier in pregnancy, such as 8 or 9 weeks of gestation. The postulated mechanisms for the fetal injury included blood loss, hypoperfusion, hypoxia, endothelial cell damage, hemorrhage, and tissue loss. The effect was most common in tissues with end arteries, such as digits, tongue, brain stem, and intestine. The associated hemangiomas were infantile hemangiomas. They were more common on the head, neck, and thorax and more often multiple in infants exposed to CVS. One postulated mechanism for the occurrence of these hemangiomas is embolization of angioblasts or endothelial cells from the placenta to the fetal skin. A question to be answered is whether the infantile hemangiomas in children exposed to CVS differ in immunohistologic characteristics from similar hemangiomas in children not exposed to CVS during pregnancy.
Holmes
Lewis B
LB
Genetics Unit, MassGeneral Hospital for Children, Boston, Massachusetts 02114, USA. holmes.lewis@mgh.harvard.edu
D000652:Amniotic Band Syndrome / Q000209:etiology; D002675:Child, Preschool; D015193:Chorionic Villi Sampling / Q000009:adverse effects*; D005260:Female; D005333:Fetus / Q000098:blood supply*; D006258:Head and Neck Neoplasms / Q000209:etiology*; D006391:Hemangioma / Q000209:etiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017880:Limb Deformities, Congenital / Q000209:etiology; D009389:Neovascularization, Pathologic; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011297:Prenatal Exposure Delayed Effects