Publication:

Exclusive transabdominal trans-amniotic approach for chorionic villus sampling in posterior placenta: a novel approach for prenatal diagnosis of genetic disorders

Background The objective of the study was to evaluate role and safety of transabdominal trans-amniotic approach for Chorionic villus sampling (CVS) for prenatal diagnosis of genetic disorders.

Methods Retrospective analytical study carried out on data form couples coming for pre-natal diagnosis from January 2010 to February 2021. Patient related parameters like age, gestational age; procedure related parameters like amount of sample, number of attempts required; different genetic disorder diagnosed and complications by both the approaches of CVS were recorded and analyzed.

Results Total 2287 patients undergoing CVS with mean age of 27±3.3 years were included. Majority (1621;70.9%) had CVS procedure at gestational age of 12-14 weeks. On analyzing physician’s perception, 663 (29%) patients having complete posterior placenta could not be accessible with routine trans-abdominal CVS and opted for trans-amniotic approach. Amount of sample yield and number of attempts were not statistically significant (p>0.05) by both methods of CVS. Thalassemia major was found in 948 (41.45%) followed by thalassemia minor in 525 (22.96%) patients. No statistically significant difference was found for developing complications by both the methods (p>0.05). Most common complication was pain and discomfort which was relieved by simple analgesics. Out of total 17 (0.74%) abortions; 13 (0.80%) from routine transabdominal and 4 (0.60%) from trans-amniotic route CVS with no statistically significant difference among them (p>0.05). No case of post procedure infection was observed.

Conclusions In complete posterior placenta CVS procedures usually postponed by most physicians leading to delay in diagnosis of genetic disorders. The novel method transabdominal trans-amniotic approach for CVS is effective and safe in skilled hands and can help in early prenatal diagnosis of genetic disorders.