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Monni G, Corda V, Iuculano A, Afshar Y. Efficacy, safety, and success of 18- versus 20-gauge needle for transabdominal chorionic villus sampling in a high-volume training setting. Prenat Diagn 2020; 41:8-10. [PMID: 33067848 DOI: 10.1002/pd.5845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/13/2020] [Accepted: 10/13/2020] [Indexed: 11/11/2022]
Affiliation(s)
- Giovanni Monni
- Department of Obstetrics and Gynecology, Prenatal and Preimplantation Genetic Diagnosis, Fetal Therapy, Microcitemico Pediatric Hospital "Antonio Cao", Cagliari, Italy
| | - Valentina Corda
- Department of Obstetrics and Gynecology, Prenatal and Preimplantation Genetic Diagnosis, Fetal Therapy, Microcitemico Pediatric Hospital "Antonio Cao", Cagliari, Italy
| | - Ambra Iuculano
- Department of Obstetrics and Gynecology, Prenatal and Preimplantation Genetic Diagnosis, Fetal Therapy, Microcitemico Pediatric Hospital "Antonio Cao", Cagliari, Italy
| | - Yalda Afshar
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Los Angeles, Los Angeles, California, USA
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Bakker M, Birnie E, Robles de Medina P, Sollie KM, Pajkrt E, Bilardo CM. Total pregnancy loss after chorionic villus sampling and amniocentesis: a cohort study. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2017; 49:599-606. [PMID: 27255564 DOI: 10.1002/uog.15986] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 05/29/2016] [Accepted: 05/31/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVES To identify maternal-, operator- and procedure-related variables that affect procedure-related pregnancy loss after transcervical (TC) and transabdominal (TA) chorionic villus sampling (CVS) and amniocentesis and to estimate the rates of spontaneous and procedure-related loss in comparable subgroups of women. METHODS This was a retrospective cohort study conducted at the University Medical Center Groningen and the Academic Medical Center, The Netherlands. Databases of both centers were searched to identify singleton pregnancies that had undergone a combined test and/or anomaly scan at around 20 weeks' gestation, or an invasive procedure (CVS and/or amniocentesis) between January 2001 and December 2011. Maternal characteristics, obstetric history, technical aspects of the invasive procedure, ultrasound examinations and fetal and neonatal outcomes were available for 29 201 cases. Women were categorized, according to the type of examination they had received, into the following five groups: first-trimester combined test (and 20-week anomaly scan); 20-week anomaly scan only; CVS; amniocentesis; amniocentesis after unsuccessful CVS. Rates of fetal loss were compared between groups. RESULTS Variables significantly associated with a higher rate of fetal loss were, for CVS, repeat attempts during the procedure, use of TC cannula instead of biopsy forceps, gestational age at procedure ≥ 13 weeks and a pregnancy after assisted reproductive techniques, and, for amniocentesis, if indication was fetal anomaly or family history of anomalies and repeat attempts during the procedure. In women aged ≥ 36 years who did not undergo an invasive procedure, spontaneous fetal loss rate (FLR) after first-trimester combined test was 1.40%, whereas after CVS, FLR was 2.76% and 2.43% for a TC and TA approach, respectively. The additional risk of fetal loss with TC-CVS was therefore 1.36% (1 : 74), which varied according to the instrument used (0.27% for forceps and 3.12% for cannula), and with TA-CVS was 1.03% (1 : 97). In women aged ≥ 36 years who underwent a 20-week anomaly scan only, spontaneous FLR was 0.63%. In women who underwent amniocentesis solely because of advanced maternal age, FLR was 1.11%. The additional risk of fetal loss with amniocentesis was 0.48% (1 : 208). CONCLUSION The total rate of procedure-related fetal loss after TA- and TC-CVS and amniocentesis appears lower than the risks on which women are currently counseled. There was a trend for a decrease in risk when the level of experience of the operator increased. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- M Bakker
- Department of Obstetrics and Gynecology, Fetal Medicine Unit, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - E Birnie
- Department of Obstetrics and Gynecology, Fetal Medicine Unit, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - P Robles de Medina
- Department of Obstetrics and Gynecology, Fetal Medicine Unit, Academic Medical Center, Amsterdam, The Netherlands
| | - K M Sollie
- Department of Obstetrics and Gynecology, Fetal Medicine Unit, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - E Pajkrt
- Department of Obstetrics and Gynecology, Fetal Medicine Unit, Academic Medical Center, Amsterdam, The Netherlands
| | - C M Bilardo
- Department of Obstetrics and Gynecology, Fetal Medicine Unit, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Pietropolli A, Capogna MV, Cascella R, Germani C, Bruno V, Strafella C, Sarta S, Ticconi C, Marmo G, Gallaro S, Longo G, Marsella LT, Novelli A, Novelli G, Piccione E, Giardina E. Three-hour analysis of non-invasive foetal sex determination: application of Plexor chemistry. Hum Genomics 2016; 10:9. [PMID: 27044517 PMCID: PMC4820952 DOI: 10.1186/s40246-016-0066-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 03/28/2016] [Indexed: 11/26/2022] Open
Abstract
Background The knowledge of the individual genetic “status” in the prenatal era is particularly relevant in the case of positive family history for genetic diseases, in advanced maternal age and in the general screening for foetal abnormalities. In this context, here, we report an innovative molecular assay which utilizes the cell-free foetal DNA (cffDNA) as a source for the early and fast detection of the foetal sex. The study involved 132 pregnant women in their first 3 months of pregnancy, who agreed to give a blood sample. All the collected samples were immediately subjected to the separation of the plasma, which was utilized for the extraction of the cffDNA. Successively, the extracted cffDNA was analysed by a quantitative PCR (qPCR) method based on Plexor-HY chemistry, which is able to simultaneously identify, quantify and discriminate the autosomal DNA from the sex-linked DNA. Results Overall, the Plexor-HY assay demonstrated to be sensitive and specific for the determination of low-template DNA, such as the cffDNA. In fact, the Plexor-HY assay has been successfully performed in all the samples, identifying 70 males and 62 females. As the foetal sex can be provided in 120 min just by utilizing a maternal blood sample as cffDNA source, the assay represents a very fast, safe and non-invasive prenatal method. Conclusions The possibility of determining the foetal sex in the early prenatal life consents the application of our assay as a helpful screening test for subjects and families at risk of sex-linked disorders. Moreover, the early knowledge of the foetal sex may be of great help even for the specialist, who might promptly advise the patients concerning the foetal risk of inheriting sex-linked disorders and the clinical utility of performing an invasive prenatal diagnosis. Electronic supplementary material The online version of this article (doi:10.1186/s40246-016-0066-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Adalgisa Pietropolli
- Section of Gynecology and Obstetrics, Academic Department of Biomedicine and Prevention, "Tor Vergata" University Hospital, Oxford Street, 81, 00133, Rome, Italy.,Clinical Department of Surgery, "Tor Vergata" University Hospital, Oxford Street, 81, 00133, Rome, Italy
| | - Maria Vittoria Capogna
- Section of Gynecology and Obstetrics, Academic Department of Biomedicine and Prevention, "Tor Vergata" University Hospital, Oxford Street, 81, 00133, Rome, Italy.,Clinical Department of Surgery, "Tor Vergata" University Hospital, Oxford Street, 81, 00133, Rome, Italy
| | - Raffaella Cascella
- Department of Biomedicine and Prevention, School of Medicine, University of Rome "Tor Vergata", Montpelier Street, 1, 00133, Rome, Italy. .,Emotest Laboratory, M. Licola Patria Street, 60, 80078, Pozzuoli, NA, Italy.
| | - Chiara Germani
- Molecular Genetics Laboratory UILDM, Santa Lucia Foundation, Ardeatina Street, 306, 00142, Rome, Italy
| | - Valentina Bruno
- Section of Gynecology and Obstetrics, Academic Department of Biomedicine and Prevention, "Tor Vergata" University Hospital, Oxford Street, 81, 00133, Rome, Italy.,Clinical Department of Surgery, "Tor Vergata" University Hospital, Oxford Street, 81, 00133, Rome, Italy
| | - Claudia Strafella
- Department of Biomedicine and Prevention, School of Medicine, University of Rome "Tor Vergata", Montpelier Street, 1, 00133, Rome, Italy
| | - Simona Sarta
- Section of Gynecology and Obstetrics, Academic Department of Biomedicine and Prevention, "Tor Vergata" University Hospital, Oxford Street, 81, 00133, Rome, Italy.,Clinical Department of Surgery, "Tor Vergata" University Hospital, Oxford Street, 81, 00133, Rome, Italy
| | - Carlo Ticconi
- Section of Gynecology and Obstetrics, Academic Department of Biomedicine and Prevention, "Tor Vergata" University Hospital, Oxford Street, 81, 00133, Rome, Italy.,Clinical Department of Surgery, "Tor Vergata" University Hospital, Oxford Street, 81, 00133, Rome, Italy
| | - Giusy Marmo
- Department of Biomedicine and Prevention, School of Medicine, University of Rome "Tor Vergata", Montpelier Street, 1, 00133, Rome, Italy
| | - Sara Gallaro
- Department of Biomedicine and Prevention, School of Medicine, University of Rome "Tor Vergata", Montpelier Street, 1, 00133, Rome, Italy
| | - Giuliana Longo
- Department of Biomedicine and Prevention, School of Medicine, University of Rome "Tor Vergata", Montpelier Street, 1, 00133, Rome, Italy
| | - Luigi Tonino Marsella
- Department of Biomedicine and Prevention, School of Medicine, University of Rome "Tor Vergata", Montpelier Street, 1, 00133, Rome, Italy
| | - Antonio Novelli
- Bambino Gesù Children's Hospital, IRCCS, Sant'Onofrio Square, 4, Rome, Italy
| | - Giuseppe Novelli
- Department of Biomedicine and Prevention, School of Medicine, University of Rome "Tor Vergata", Montpelier Street, 1, 00133, Rome, Italy
| | - Emilio Piccione
- Section of Gynecology and Obstetrics, Academic Department of Biomedicine and Prevention, "Tor Vergata" University Hospital, Oxford Street, 81, 00133, Rome, Italy.,Clinical Department of Surgery, "Tor Vergata" University Hospital, Oxford Street, 81, 00133, Rome, Italy
| | - Emiliano Giardina
- Department of Biomedicine and Prevention, School of Medicine, University of Rome "Tor Vergata", Montpelier Street, 1, 00133, Rome, Italy.,Molecular Genetics Laboratory UILDM, Santa Lucia Foundation, Ardeatina Street, 306, 00142, Rome, Italy
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