A Multi-centre Experience of Trans-abdominal Chorionic Villus Sampling in Pakistan.

ABSTRACT

OBJECTIVE: To determine the safety and outcomes of trans-abdominal chorionic villus sampling technique. STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY Departments of Obstetrics and Gynaecology, PNS Shifa Karachi, Pak-Emirates Military Hospital Rawalpindi and CMH Lahore, from 2005-2020.   Methodology: A total of 1530 consecutive chorionic villus samplings (CVS) were performed on pregnant females between 10-20 weeks of gestation using the transabdominal approach. Patients were subjected to integrated, stepwise sequential screening. Analysis of data was based on demographic features, indications for sampling, gestational age, attempts of CVS, needle aspiration time, assessment, placental location, sample yield, complications, pain estimation by visual analogue scale (VAS), CVS culture results and pregnancy outcomes. RESULTS: The most common indication for CVS was couple having thalassemia traits and history of having a thalassemia major child previously (55.2%). Pain was the most common complication (64.1%). Procedure-related pregnancy loss (considered to be till 20 weeks of gestation) was observed in two cases (0.1%) only. The most common abnormal karyotype was found to be ß-Thalassemia trait (23.6%) followed by ß-Thalassemia major (22.1%) and Trisomy 21(16.8%). No abnormality was detected in 33.5% of the cases. Five hundred and eighty-nine (38.4%) interruptions of pregnancies were done on the basis of CVS results. CONCLUSION: CVS is a safe and useful technique for sampling in prenatal diagnosis of genetic disorders, markedly affecting the management. KEY WORDS Chorionic villus sampling, Pre-natal diagnosis, Karyotype.