Role of Interventional Procedure in Current Obstetrics
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2018, Vol 3, Issue 4
Abstract
Objective: The main purpose of this study was to elucidate the main clinical indications, diagnostic yield and complications regarding interventional procedures. Study Design: An observational, prospective study was conducted on all women who underwent amniocenteses and chorionic villus sampling between February 2015 and January 2018. Methods: All samples which came to the Genetics laboratory, obtained by invasive procedures (amniocentesis and chorionic villous sampling [CVS]), performed during pregnancy, between February 2015 and January 2018 were included in the study. Maternal demographics, indication for amniocentesis, types of chromosomal aberration, gestational age at the time of amniocentesis and procedure-related complications during pregnancy data were analyzed using SPSS (version 20.0). Results: A total of 192 samples were included in the study. 16 women underwent CVS, the main indication being ultrasound detection of cystic hygroma. 176 women underwent amniocentesis for various indications. The commonest indication for amniocentesis was ultrasound marker positive for aneuploidy 85 (44.3%) followed by ultrasonographically detected malformations 34 (17.6%). Fluorescence In situ Hybridization (FISH) was also performed in 73 cases for rapid results and the most common indication being ultrasound soft marker positive followed by maternal serum screening positive (MSS). Abnormal karyotypes were obtained in 15 cases (7.9%) . The clinical indications with highest positive predictive values were parent carrier of chromosome abnormality (40%) and ultrasonographically detected malformations (17.6%). There was only one woman with twin gestation (DCDA) and severe polyhydramnios, who post-amniocentesis went into preterm labour within 48 hours of the procedure (0.4%). Conclusions: At a referral centre like ours, where high risk women and women referred from outside are mainly catered to, we found that amniocentesis based abnormal ultrasonographic findings, is a time tested proven technique with very low complication rates in detection of chromosomal abnormalities.
Authors and Affiliations
Dr. Pritti Priya
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