Chorionic Villus Sampling at 11 to 13 Weeks Not Linked to Hypertensive Disorders in Pregnancy

Laurie Barclay, MD

August 16, 2010

August 16, 2010 — Chorionic villus sampling (CVS) at 11 to 13 weeks of gestation is not linked to hypertensive disorders in pregnancy, according to the results of a study reported in the August issue of Obstetrics & Gynecology.

"There is conflicting evidence in the literature about whether ...CVS in early pregnancy increases the risk of preeclampsia," write Asma Khalil, MD, from University College Hospital, London, United Kingdom, and colleagues. "The aim of our study was to estimate the potential association of CVS at 11 to 14 weeks of gestation with subsequent development of hypertensive disorders in pregnancy by comparison with a large, unselected screening population and to estimate whether any such association remains significant after adjusting for maternal serum concentration of [pregnancy-associated plasma protein-A (PAPP-A)] and maternal characteristics that are known to contribute to the development of preeclampsia."

The study sample consisted of live singleton pregnancies at 11-0/7 to 13-6/7 weeks surviving past 23 weeks of gestation for which measurements of free beta–human chorionic gonadotropin (hCG) and PAPP-A were available. Pregnancies ending in miscarriage or termination before 24 weeks of gestation, women in whom pregnancy outcome was unknown, and women who had an amniocentesis were excluded. Using multiple logistic regression analysis, the investigators examined whether CVS in conjunction with maternal and pregnancy characteristics were significant predictors of the development of preeclampsia and gestational hypertension.

Of 31,138 study participants, 697 (2.2%) had preeclampsia, and 857 (2.8%) had gestational hypertension. CVS was performed in 2278 participants (7.3%). For these outcomes, significant maternal and serum biochemistry predictors were identified from multiple logistic regression analysis. However, undergoing a CVS in the first trimester did not contribute significantly to subsequent development of early preeclampsia (P = .677), late preeclampsia (P = .535), or gestational hypertension (P = .848).

Limitations of this study include observational design.

"There is no association between performing a CVS in the first trimester and subsequent development of hypertensive disorders of pregnancy," the study authors write. "Our results do not support the hypothesis that anatomic focal disruption of the placenta at 11 to 14 weeks of gestation leads to an increase in the risk of either preeclampsia or gestational hypertension."

The Fetal Medicine Foundation supported this study. The study authors have disclosed no relevant financial relationships.

Obstet Gynecol. 2010;116:374-380.

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