[Initial experiences with a new catheter-controlled chorionic villi sampling technique].
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In the first trimester of pregnancy two simple chorionic villus sampling method, carried out under ultrasound guidance, with transabdominal or transcervical aspiration, was evaluated in 257 cases at risk for chromosomic diseases. The high efficacy of the transabdominal aspiration was demonstrated by obtain villus tissue for karyotyping in all but one case. In only one sample the abnormalities detected were not confirmed (one case of false positive).
The results of a retrospective assessment of the first 112 chorion villus biopsies carried out in the Department of Obstetrics and Gynaecology in the Central Hospital in Randers are presented. Karyotype determination was obtained in 98.2% and in 83.9% already by means of direct microscopic examination after incubation for 24 hours. No complications which could be attributed to the biopsies were registered. The present authors consider that the method should be employed more extensively for prenatal cytogenetic diagnosis.
Detail studies on a diastasic digested leucofuxin coloured citotrofoblastic and synciziotrophoblastic villus cells permitted to localize chorion glicoprotein concentration almost exclusively in the proximal portion of the trophoblastic syncitium. Furthermore, like in the epatic tissue, but unlike the findings in some other sites such as sarcolemma, necrilemm basal membranes, the reticula villus substance is argirofila but not P.A.S. positive. Some considerations were proposed to explain this abnormal pattern.
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At the Gynecological Clinic of the Klinikum Ludwigshafen prenatal transabdominal diagnostic aspiration of villi was performed in 120 cases in the first and second trimesters between October 1986 and April 1988. The puncture was performed using a cannula system comprising a guide and an aspiration needle. The ultrasonographically controlled removal technique is described with special consideration of the procedure in cases with placental insertion in the posterior wall. Successful tissue removal (at least 5 mg of tissue) was achieved in 97.5% of the cases. Cytogenetic, biochemical, and molecular biologic studies were performed. The most frequent indication was to detect chromosome disorders in older mothers (74.2%). Such disorders were diagnosed in 4.2% of all cases and pregnancy was terminated in seven of them; the indications were aneuploidies, metabolic disease, or severe developmental anomalies detected by ultrasonography in normal karyotypes. In the remaining 113 pregnancies one miscarriage was seen nine weeks after aspiration of villi. On the basis of these results the abortion risk following transabdominal chorionic biopsy is 0.88% and is thus similar to that following amniocentesis.
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