j. Perinat. Med. Chorionic villi sampling with an echogenic catheter: experiences of 15(1987)244 the first 500 cases

Since chorionic villus sampling (CVS) was established as a first-trimester alternative to amniocentesis for the prenatal detection of genetic disorders four years ago [3, 15, 16], three major reports from different centers with about 1000 cases each have recently provided valuable informations on the safety of sampling and the reliability of diagnosis [4, 13, 17]. An editorial in the "Lancet" at the beginning of 1986 concluded from the discussion at the 2nd International Conference on CVS in Birmingham that "the best technique of CVS is not yet agreed" [1]. Most samples are at present obtained transcervically by a specific type of plastic catheter with a bendable aluminum obturator which was originally developed by H. WARD [15]. A disadvantage of this particular instrument can be an occasionally significant reduction in visibility on the ultrasound screen after removal of the metal obturator with resulting loss of control over the catheter tip during sampling. We therefore started in 1984 to develop a CVS catheter with improved echogenicity [5] and ultimately have used in our diagnostic series a transparent polyethylene catheter (figure 1 a) with a highly echogenic stripe in its wall (figure 1 b). Here our experience with more than 500 diagnostic cases using this technique and their complete follow-up according to an investigative protocol is reported. Curriculum vitae