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The decline of amniocentesis and the increase of chorionic villus sampling in modern perinatal medicine

  • Giovanni Monni EMAIL logo , Valentina Corda , Ambra Iuculano and Yalda Afshar
Published/Copyright: March 19, 2020

Abstract

Objective

The aims of this study were to determine the rate of change by type of diagnosis by transabdominal chorionic villus sampling (TA-CVS) vs. amniocentesis for aneuploidy and to describe a successful and intensive international training program for TA-CVS in ongoing pregnancies.

Methods

We conducted a retrospective cohort study of all deliveries from 2010 to 2018 in Sardinia. All invasive diagnostic procedures are conducted at a single regional perinatal referral center. Descriptive statistics were used to compare data across groups, and inter-correlations between variables were investigated by Pearson’s correlation coefficient. We subsequently describe the international trainee experiences in TA-CVS over a 35-year period.

Results

A total of 101,025 deliveries occurred over 9 years. The number of deliveries (13,413–9143, P < 0.0001) and total invasive diagnostic procedures (1506–858 per year, P = 0.019) declined over this period. The percentage of deliveries undergoing invasive diagnostic procedures remained steady (mean: 12.2%). In 2010, TA-CVS made up 32.3% of all invasive diagnostic procedures, while amniocentesis made up 67.7%. By 2018, TA-CVS made up 61.3% of the invasive diagnostic procedures, and amniocentesis, only 38.7%. The rate of TA-CVS increased over 9 years, while the rate of amniocentesis declined. A total of 236 trainees from 39 different countries and 5 different continents rotated through this site. The average length of stay was 2.4 weeks.

Conclusion

We demonstrate an increasing prevalence of TA-CVS vs. amniocentesis in the current era of prenatal testing and underscore the importance of continuing to train specialists skilled in TA-CVS. Our global operative experience is feasible and sustainable and will have a lasting impact on physicians conducting invasive fetal procedures.


Corresponding author: Giovanni Monni, MD, Department of Obstetrics and Gynecology, Prenatal and Preimplantation Genetic Diagnosis, Fetal Therapy, Microcitemico Pediatric Hospital “Antonio Cao”, via Edward Jenner SNC, Cagliari, 09121 Sardinia, Italy

Acknowledgments

The authors of this manuscript would like to thank Fondazione di Sardegna for their encouraging trust and Boyana Petrova Tsikalova, MA, for editing assistance.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Conflict of interest: None declared.

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Received: 2020-01-31
Accepted: 2020-02-21
Published Online: 2020-03-19
Published in Print: 2020-04-28

©2020 Walter de Gruyter GmbH, Berlin/Boston

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