Chorionic villus sampling (CVS) for prenatal diagnosis of genetic disorders in Bangladesh

Abstract

Objective(s): The aim of the study was to identify safety and outcome of trans abdominal Chorionic Villus Sampling (CVS) for prenatal diagnosis of genetic disorders. Materials and methods: This is a retrospective analytical study on women who had undergone trans abdominal CVS. All CVS were done at Fetal medicine centre, Family Foundation, Green Road, Dhaka, from June 2013 to December 2016. A total of 286 couples, who were referred for prenatal diagnosis of various genetic disorders were studied. Trans abdominal CVS was done under local anesthesia and real-time ultrasound guidance. A 18G/88mm Spinal Needle (B Braun, Germany) was used. All CVS were performed with the "2 operators" technique. The needle was introduced trans abdominally into the placenta in its longitudinal direction. Once the needle was adequately placed, the chorionic villi were aspirated with a to and fro jiggling movement of the aspiration needle and a suction force was applied through a syringe. Results were recorded and analyzed for descriptive statistics. Results: A total of 286 CVSs were performed as outdoor basis. The most common indication was detecting Beta-thalassaemia (82.5%). Other indications were for diagnosis of aneuploidy (9.7%), Hemophilia (3.1%), Spinal muscular atrophy (SMA) (2.4%), Duchenne Muscular Dystrophy (DMD) (2%). Most procedures were done between 11 and 13 weeks (range 11-14 weeks). Most aspirations (95.1%) were easy; however, in 4.8% cases the aspiration was difficult due to a variety of factors. The overall success rate was 100%. Minor complications like placental hematoma and pervaginal (P/V) bleeding occurred in 2% and 1.3% respectively, which were subsided by conservative management. The procedure related miscarriage within three weeks not occurred in any cases. Conclusion: Trans abdominal CVS under real-time sonography is a useful outdoor procedure for prenatal diagnosis in early pregnancy without significant risk to the mother and the fetus.