Risk of miscarriage following amniocentesis or chorionic villus sampling: systematic review of literature and updated meta-analysis.
Abortion, Spontaneous
/ etiology
Adult
Amniocentesis
/ adverse effects
Chorionic Villi Sampling
/ adverse effects
Chromosome Aberrations
/ statistics & numerical data
Embryo Loss
/ epidemiology
Female
Gestational Age
Humans
Pregnancy
Pregnancy Trimester, Second
Prenatal Diagnosis
Randomized Controlled Trials as Topic
Risk Assessment
CVS
amniocentesis
chorionic villus sampling
fetal loss
miscarriage
pregnancy loss
prenatal diagnosis
procedure-related loss
Journal
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
ISSN: 1469-0705
Titre abrégé: Ultrasound Obstet Gynecol
Pays: England
ID NLM: 9108340
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
received:
15
04
2019
revised:
02
05
2019
accepted:
03
05
2019
pubmed:
28
5
2019
medline:
17
3
2020
entrez:
25
5
2019
Statut:
ppublish
Résumé
To estimate the procedure-related risk of miscarriage after amniocentesis and chorionic villus sampling (CVS) based on a systematic review of the literature and an updated meta-analysis. A search of MEDLINE, EMBASE and The Cochrane Library was carried out to identify studies reporting complications following CVS or amniocentesis. Eligible for inclusion were large controlled studies reporting data for pregnancy loss prior to 24 weeks' gestation. Study authors were contacted when required to identify additional necessary data. Data for cases that had an invasive procedure and controls were inputted into contingency tables and the risk of miscarriage was estimated for each study. Summary statistics based on a random-effects model were calculated after taking into account the weighting for each study included in the systematic review. Procedure-related risk of miscarriage was estimated as a weighted risk difference from the summary statistics for cases and controls. Subgroup analyses were performed according to the similarity in risk levels for chromosomal abnormality between the invasive-testing and control groups. Heterogeneity was assessed using the I The electronic search yielded 2943 potential citations, from which 12 controlled studies for amniocentesis and seven for CVS were selected for inclusion in the systematic review. A total of 580 miscarriages occurred following 63 723 amniocentesis procedures, resulting in a weighted risk of pregnancy loss of 0.91% (95% CI, 0.73-1.09%). In the control group, there were 1726 miscarriages in 330 469 pregnancies with a loss rate of 0.58% (95% CI, 0.47-0.70%). The weighted procedure-related risk of miscarriage following amniocentesis was 0.30% (95% CI, 0.11-0.49%; I The procedure-related risks of miscarriage following amniocentesis and CVS are lower than currently quoted to women. The risk appears to be negligible when these interventions were compared to control groups of the same risk profile. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd. Riesgo de aborto después de una amniocentesis o una biopsia de vellosidades coriónicas: revisión sistemática de bibliografía y metaanálisis actualizado OBJETIVO: Estimar el riesgo de aborto relacionado con el procedimiento de la amniocentesis o la biopsia de vellosidades coriónicas (BVC) mediante una revisión sistemática de bibliografía y un metaanálisis actualizado. MÉTODOS: Se realizó una búsqueda en MEDLINE, EMBASE y The Cochrane Library para identificar estudios que reportaron sobre complicaciones después de una BVC o amniocentesis. Se consideraron elegibles para su inclusión los estudios controlados de gran tamaño que reportaron datos sobre la pérdida del embarazo antes de las 24 semanas de gestación. Se estableció contacto con los autores de los estudios cuando fue necesario para identificar datos adicionales necesarios. Se introdujeron en tablas de contingencia los datos de los casos que se sometieron a un procedimiento invasivo y controles y se estimó el riesgo de aborto para cada estudio. Las estadísticas resumen basadas en un modelo de efectos aleatorios se calcularon después de tener en cuenta la ponderación para cada estudio incluido en la revisión sistemática. El riesgo de aborto relacionado con cada procedimiento se estimó como una diferencia de riesgo ponderada de las estadísticas resumen para los casos y controles. Los análisis de subgrupos se realizaron de acuerdo con la similitud en los niveles de riesgo de anomalías cromosómicas entre los grupos de prueba invasiva y de control. La heterogeneidad se evaluó mediante el test estadístico I 羊膜穿刺术或绒毛膜绒毛取样后的流产风险:相关文献的系统评估及最新的元分析 目标: 依据相关文献的系统评估及最新的元分析，估算羊膜穿刺术与绒毛膜绒毛取样(CVS)后的程序相关性流产风险。 方法: 检索了MEDLINE、EMBASE及科克伦图书馆藏文献(Cochrane Library)，寻找一些报告CVS或羊膜穿刺术之后出现并发症的研究案例。符合纳入标准的是妊娠24周前报告妊娠失败数据的大型对照研究。需要时联系了研究作者，以确定其他必要的数据。将几个侵入性程序与对照案例的数据输入了列联表，估算了每项研究的流产风险。考虑了系统评估中包括的每项研究的权重后，计算了基于随机效应模型的汇总统计。针对相关案例和对照组汇总统计数据，以加权风险差异的形式估算了程序相关性流产风险。根据侵入性测试组和对照组之间的染色体异常风险水平相似性，进行了亚组分析。通过I
Autres résumés
Type: Publisher
(spa)
Riesgo de aborto después de una amniocentesis o una biopsia de vellosidades coriónicas: revisión sistemática de bibliografía y metaanálisis actualizado OBJETIVO: Estimar el riesgo de aborto relacionado con el procedimiento de la amniocentesis o la biopsia de vellosidades coriónicas (BVC) mediante una revisión sistemática de bibliografía y un metaanálisis actualizado. MÉTODOS: Se realizó una búsqueda en MEDLINE, EMBASE y The Cochrane Library para identificar estudios que reportaron sobre complicaciones después de una BVC o amniocentesis. Se consideraron elegibles para su inclusión los estudios controlados de gran tamaño que reportaron datos sobre la pérdida del embarazo antes de las 24 semanas de gestación. Se estableció contacto con los autores de los estudios cuando fue necesario para identificar datos adicionales necesarios. Se introdujeron en tablas de contingencia los datos de los casos que se sometieron a un procedimiento invasivo y controles y se estimó el riesgo de aborto para cada estudio. Las estadísticas resumen basadas en un modelo de efectos aleatorios se calcularon después de tener en cuenta la ponderación para cada estudio incluido en la revisión sistemática. El riesgo de aborto relacionado con cada procedimiento se estimó como una diferencia de riesgo ponderada de las estadísticas resumen para los casos y controles. Los análisis de subgrupos se realizaron de acuerdo con la similitud en los niveles de riesgo de anomalías cromosómicas entre los grupos de prueba invasiva y de control. La heterogeneidad se evaluó mediante el test estadístico I
Type: Publisher
(chi)
羊膜穿刺术或绒毛膜绒毛取样后的流产风险:相关文献的系统评估及最新的元分析 目标: 依据相关文献的系统评估及最新的元分析，估算羊膜穿刺术与绒毛膜绒毛取样(CVS)后的程序相关性流产风险。 方法: 检索了MEDLINE、EMBASE及科克伦图书馆藏文献(Cochrane Library)，寻找一些报告CVS或羊膜穿刺术之后出现并发症的研究案例。符合纳入标准的是妊娠24周前报告妊娠失败数据的大型对照研究。需要时联系了研究作者，以确定其他必要的数据。将几个侵入性程序与对照案例的数据输入了列联表，估算了每项研究的流产风险。考虑了系统评估中包括的每项研究的权重后，计算了基于随机效应模型的汇总统计。针对相关案例和对照组汇总统计数据，以加权风险差异的形式估算了程序相关性流产风险。根据侵入性测试组和对照组之间的染色体异常风险水平相似性，进行了亚组分析。通过I
Types de publication
Comparative Study
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
442-451Informations de copyright
Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
Références
Ghi T, Sotiriadis A, Calda P, Da Silva Costa F, Raine-Fenning N, Alfirevic Z, McGillivray G; International Society of Ultrasound in Obstetrics and Gynecology (ISUOG). ISUOG Practice Guidelines: invasive procedures for prenatal diagnosis. Ultrasound Obstet Gynecol 2016; 48: 256-268.
Royal College of Obstetricians and Gynaecologists. Amniocentesis and Chorionic Villus Sampling. Green-top guideline No.8. RCOG Press: London, 2010.
Invasive prenatal testing for aneuploidy. ACOG Practice Bulletin No. 88, December 2007. American College of Obstetricians and Gynecologists. Obstet Gynecol 2007; 110: 1459-1467.
Akolekar R, Beta J, Picciarelli G, Ogilvie C, D'Antonio F. Procedure-related risk of miscarriage following amniocentesis and chorionic villus sampling: a systematic review and meta-analysis. Ultrasound Obstet Gynecol 2015; 45: 16-26.
Beta J, Lesmes-Heredia C, Bedetti C, Akolekar R. Risk of miscarriage following amniocentesis and chorionic villus sampling: a systematic review of the literature. Minerva Ginecol 2018; 70: 215-219.
Wulff CB, Gerds TA, Rode L, Ekelund CK, Petersen OB, Tabor A; Danish Fetal Medicine Study Group. Risk of fetal loss associated with invasive testing following combined first-trimester screening for Down syndrome: a national cohort of 147 987 singleton pregnancies. Ultrasound Obstet Gynecol 2016; 47: 38-44.
Bakker M, Birnie E, Robles de Medina P, Sollie KM, Pajkrt E, Bilardo CM. Total pregnancy loss after chorionic villus sampling and amniocentesis: a cohort study. Ultrasound Obstet Gynecol 2017; 49: 599-606.
Wah YM, Leung TY, Cheng YKY, Sahota DS. Procedure-Related Fetal Loss following Chorionic Villus Sampling after First-Trimester Aneuploidy Screening. Fetal Diagn Ther 2017; 41: 184-190.
Theodora M, Antsaklis A, Blanas K, Antsaklis P, Daskalakis G, Sindos M, Mesogitis S, Papantoniou N. Risk for fetal loss and prematurity after 12 413 second-trimester amniocenteses in a single center. J Perinat Med 2015; 43: 347-351.
Malan V, Bussières L, Winer N, Jais JP, Baptiste A, Le Lorc'h M, Elie C, O'Gorman N, Fries N, Houfflin-Debarge V, Sentilhes L, Vekemans M, Ville Y, Salomon LJ; SAFE 21 Study Group. Effect of Cell-Free DNA Screening vs Direct Invasive Diagnosis on Miscarriage Rates in Women With Pregnancies at High Risk of Trisomy 21: A Randomized Clinical Trial. JAMA 2018; 320: 557-565.
Beta J, Zhang W, Geris S, Kostiv V, Akolekar R. Procedure-related risk of miscarriage following chorionic villus sampling and amniocentesis. Ultrasound Obstet Gynecol 2019; 54: 452-457.
Survival of extremely preterm infants: Joint statement from the British Medical Association, the British Association of Perinatal Medicine, the Faculty of Sexual and Reproductive Healthcare, the Royal College of Nursing and the Royal College of Obstetricians and Gynaecologists. http://www.rcog.org.uk/files/rcog-corp/uploaded-files/JointStatementBMABAPMFSRHRCNRCOG24wkMay08.pdf.
Wells GA, Shea B, O'Connell D, Peterson J, Welch V, Losos M, Tugwell P. The Newcastle-Ottawa Scale (NOS) for assessing the quality of non-randomized studies in meta-analysis. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp.
Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. BMJ 2009; 39: b2535.
DerSimonian R, Laird N: Meta-analysis in clinical trials. Control Clin Trials 1986; 7: 177-188.
Cochran WG. The combination of estimates from different experiments. Biometrics 1954; 10: 101-129.
Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003; 327: 557-560.
Egger M, Davey Smith G, Schneider M, Minder C: Bias in meta-analysis detected by a simple, graphical test. BMJ 1997; 315: 629-634.
Muller F, Thibaud D, Poloce F, Gelineau MC, Bernard M, Brochet C, Millet C, Réal JY, Dommergues M. Risk of amniocentesis in women screened positive for Down syndrome with second-trimester maternal serum markers. Prenat Diagn 2002; 22: 1036-1039.
Eddleman KA, Malone FD, Sullivan L, Dukes K, Berkowitz RL, Kharbutli Y, Porter TF, Luthy DA, Comstock CH, Saade GR, Klugman S, Dugoff L, Craigo SD, Timor-Tritsch IE, Carr SR, Wolfe HM, D'Alton ME. Pregnancy loss rates after mid-trimester amniocentesis. Obstet Gynecol 2006; 108: 1067-1072.
Kong CW, Leung TN, Leung TY, Chan LW, Sahota DS, Fung TY, Lau TK. Risk factors for procedure-related fetal losses after mid-trimester genetic amniocentesis. Prenat Diagn 2006; 26: 925-930.
Towner D, Currier RJ, Lorey FW, Cunningham GC, Greve LC. Miscarriage risk from amniocentesis performed for abnormal maternal serum screening. Am J Obstet Gynecol 2007; 196: 608.e1-5.
Odibo AO, Gray DL, Dicke JM, Stamilio DM, Macones GA, Crane JP. Revisiting the fetal loss rate after second-trimester genetic amniocentesis: a single center's 16-year experience. Obstet Gynecol 2008; 111: 589-595.
Pitukkijronnakorn S, Promsonthi P, Panburana P, Udomsubpayakul U, Chittacharoen A. Fetal loss associated with second-trimester amniocentesis. Arch Gynecol Obstet 2011; 284: 793-797.
Corrado F, Cannata ML, La Galia T, Magliarditi M, Imbruglia L, D'anna R, Carlo Stella N. Pregnancy outcome following mid-trimester amniocentesis. J Obstet Gynaecol 2012; 32: 117-119.
Lau KT, Leung YT, Fung YT, Chan LW, Sahota DS, Leung NT. Outcome of 1355 consecutive transabdominal chorionic villus samplings in 1351 patients. Chin Med J (Engl) 2005; 118: 1675-1681.
Akolekar R, Bower S, Flack N, Bilardo CM, Nicolaides KH. Prediction of miscarriage and stillbirth at 11-13 weeks and the contribution of chorionic villus sampling. Prenat Diagn 2011; 31: 38-45.
Odibo AO, Dicke JM, Gray DL, Oberle B, Stamilio DM, Macones GA, Crane JP. Evaluating the rate and risk factors for fetal loss after chorionic villus sampling. Obstet Gynecol 2008; 112: 813-819.
Acharya G, Sonesson SE, Flo K, Räsänen J, Odibo A. Hemodynamic aspects of normal human feto-placental (umbilical) circulation. Acta Obstet Gynecol Scand 2016; 95: 672-682.
Assali, NS, Rauramo, L, Peltonen, T. Measurement of uterine blood flow and uterine metabolism. VIII. Uterine and fetal blood flow and oxygen consumption in early human pregnancy. Am J Obstet Gynecol 1960; 79: 86-98.
Alfirevic Z, Navaratnam K, Mujezinovic F. Amniocentesis and chorionic villus sampling for prenatal diagnosis. Cochrane Database Syst Rev. 2017; 9: CD003252.
Salomon LJ, Alfirevic Z, Audibert F, Kagan KO, Paladini D, Yeo G, Raine-Fenning N; ISUOG Clinical Standards Committee. ISUOG updated consensus statement on the impact of cfDNA aneuploidy testing on screening policies and prenatal ultrasound practice. Ultrasound Obstet Gynecol 2017; 49: 815-816.