The effect of Chorionic Villus Sampling on placental perfusion: a
prospective observational study.
Abstract
Objective- To assess the potential effect of Chorionic Villus Sampling
(CVS) on placental perfusion by examining change in uterine artery
pulsatility index (UtA-PI) between first and second trimesters of
pregnancy. Design- It was a prospective observational study conducted
between August 2017 to January 2019. Setting- Department of Obstetrics
and Gynecology, Maulana Azad Medical College, New Delhi. Study Sample-
Twenty-one singleton pregnancies where CVS was planned were included in
the case group whereas forty-two low-risk singleton pregnancies with no
invasive testing constituted the control group. Pregnancy resulting in
miscarriage or, termination of pregnancy for affected fetus, or demise
of fetus beyond 23 weeks or subsequent detection of anomaly or
chromosomal defects were excluded. Methods- Dating scan along with first
and second trimester UtA doppler study was done at 11-13+6 weeks and
22-24+6 weeks respectively using an ultrasound machine with 2-5 MHz
trans-abdominal transducer. Main Outcome Measures- The primary outcome
was to evaluate the change in UtA-PI between first and second trimesters
of women undergoing CVS and comparing it with control group. Results-
The difference between first and second trimester mean PI of case and
control group were 0.71± 0.35 and 0.44± 0.45 respectively. This
difference of fall in PI between the two groups was statistically
significant (p= 0.010) with the change being higher in the CVS group.
Conclusions- CVS does not cause undesirable effect on the UtA doppler.
UtA doppler being a predictive marker of development of pre-eclampsia or
FGR; this study affirms the safety of CVS in experienced hands.