American Journal of Obstetrics & Gynecology
Volume 201, Issue 4 , Pages 400.e1-400.e3, October 2009

Pain associated with chorionic villus sampling: transabdominal vs transcervical approach

Presented at the 29th Annual Meeting of the Society for Maternal-Fetal Medicine, San Diego, CA, Jan. 26-31, 2009.

  • Joseph R. Wax, MD

      Affiliations

    • Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Maine Medical Center, Portland, ME
    • ,
  • Norman P. Davies, MBBS

      Affiliations

    • Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, MN
    • ,
  • William J. Watson, MD

      Affiliations

    • Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, MN
    • ,
  • Angelina Cartin

      Affiliations

    • Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Maine Medical Center, Portland, ME
    • ,
  • Michael G. Pinette, MD

      Affiliations

    • Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Maine Medical Center, Portland, ME
    • ,
  • Renée Chard, MS

      Affiliations

    • Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Maine Medical Center, Portland, ME
    • ,
  • Molly Carpenter, MS

      Affiliations

    • Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Maine Medical Center, Portland, ME

Received 10 December 2008; received in revised form 20 May 2009; accepted 29 June 2009. published online 17 August 2009.

Objective

The purpose of this study was to compare anticipated and perceived pain that is associated with transabdominal and transcervical chorionic villus sampling (CVS).

Study Design

Women with singleton pregnancies who were undergoing CVS completed a preprocedure 0-10 visual analog scale (VAS; 0 = no pain, 10 = excruciating pain) for anticipated transabdominal and transcervical CVS–related pain. After the procedure, patients completed a VAS for perceived pain.

Results

One hundred twenty-one women underwent transabdominal (n = 98) or transcervical (n = 23) CVS. Anticipated pain was 4.5 ± 2.0, which was similar in patients who ultimately underwent transabdominal (score, 4.6 ± 3.8) or transcervical (score, 4.1 ± 2.2) CVS. Postprocedure perceived pain was similar for transabdominal CVS in women with an abdominal wall thickness of <4 cm (score, 2.3 ± 0.8) and transcervical CVS (score, 2.6 ± 2.2) but was significantly greater for transabdominal CVS among women with an abdominal wall thickness of ≥4 cm (score, 5.6 ± 1.2; P < .0001) and nulliparous women who had transcervical CVS (score, 4.3 ± 2.1; P = .01).

Conclusion

Transabdominal CVS is more painful in heavier women, and transcervical CVS is more painful in nulliparous women.

Key words: chorionic villus sampling, pain, prenatal diagnosis

 

 Authorship and contribution to the article is limited to the 7 authors indicated. There was no outside funding or technical assistance with the production of this article.

 Reprints not available from the authors.

 Cite this article as: Wax JR, Davies NP, Watson WJ, et al. Pain associated with chorionic villus sampling: transabdominal vs transcervical approach. Am J Obstet Gynecol 2009;201:400.e1-3.

PII: S0002-9378(09)00735-2

doi:10.1016/j.ajog.2009.06.064

American Journal of Obstetrics & Gynecology
Volume 201, Issue 4 , Pages 400.e1-400.e3, October 2009