Chorionic villus sampling: technique and training.
OBJECTIVE
Over the past decade, first trimester screening has become the gold standard prenatal screening modality in the developed world. This shift toward earlier screening would not be possible without the availability of early diagnosis, namely, chorionic villus sampling (CVS). The purpose of this review is to highlight recent updates related to CVS technique, potential complications, and training.


RESULTS
Recent data highlight the importance of operator experience in reducing CVS-related complications and argues for the 'centralization' of CVS in experienced centers. On the other hand, despite over 30 years of clinical practice, there is still no consensus regarding optimal CVS technique and some variation exists between CVS providers. Moreover, there is a deficiency in adequate infrastructure geared toward the training and certification of future CVS providers.


CONCLUSIONS
CVS is the gold standard method of first trimester prenatal diagnosis. Recent data suggest that CVS loss rates are lower than what was previously reported and are lowest in centers that perform a large number of procedures. The 'centralization' of this specialized procedure also offers the perfect opportunity for the safe, ongoing training of future CVS providers.
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Stanford University Medical Center, Stanford, California, USA.
Yair J
YJ
Blumenfeld
Jane
J
Chueh
D015193:Chorionic Villi Sampling / Q000009:adverse effects / Q000379:methods*; D002983:Clinical Competence; D004502:Education, Medical, Continuing; D005260:Female; D006801:Humans; D009774:Obstetrics / Q000193:education*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D000078329:Workforce