Chorionic villus sampling: experience with 3016 cases performed by a single operator.
OBJECTIVE: To describe our experience with 3016 first-trimester chorionic villus sampling (CVS) procedures, all performed by a single operator, to assess the influence of operator experience on the safety and efficacy of CVS. METHODS: Transcervical or transabdominal CVS procedures were performed on 3016 patients between the gestational ages of 9-12 weeks. The sampling success rate, procedure complications, cytogenetic results, and pregnancy outcomes were tabulated and analyzed. RESULTS: Samples adequate for diagnosis were obtained in 99.7% of the cases. The mean (+/- standard deviation) number of insertions per procedure was 1.1 +/- 0.4. The percentage of procedures in which the sample was obtained with a single insertion increased from 51% in the first 100 cases to 96% in the last 2516 cases. There were 56 (1.94%) first- and second-trimester pregnancy losses among 2892 pregnancies intended to continue. This loss rate compares with published baseline risk figures for miscarriage of approximately 2-3%. No difference in pregnancy loss rate followed one or two catheter or needle insertions, but the need for three insertions was associated with a significantly increased loss rate (6.7 versus 1.9%; chi 2 = 4.35, P < .05). CONCLUSION: Operator experience plays a significant role in the safety and efficacy of CVS.