( dures performed at UCSF Medical Center ...)Prenatal Test and Miscarriage,Health

dures performed at UCSF Medical Center from 1983 to 2003. Overall, the pregnancy loss rate for patients undergoing CVS was greater (3.12 percent) than that of amniocentesis (0.83 percent). However, when examining the data at five-year intervals, the difference between the two procedures coincided with the highest occurring from 1983 through 1987 and lowest from 1998 through 2003.

"We saw that the rate of miscarriage risk attributable to CVS had declined over time," said Norton. "One possible reason is that over time practitioners have become more proficient in performing CVS procedures."

When the researchers controlled for gestational age and maternal age, they found that there were no differences between the losses from CVS or amniocentesis.

Over the past several years, non-invasive screening tests for birth defects have seen marked improvement, according to Norton. While screening in the past was primarily available only in the second trimester, more recent studies have demonstrated that tests such as a specialized ultrasound of the fetal neck, known as "nuchal translucency " ultrasound, combined with early blood screening have a better detection rate and can be completed much earlier in pregnancy. Pre-screening using these techniques is often performed as the precursor for the more invasive diagnostic procedures.

"We have advanced significantly in our ability to screen for and detect birth defects," said Norton. "Where the primary criteria for determining a high risk pregnancy used to be maternal age, we are now able to perform blood tests or ultrasound in the first trimester, enabling us to determine much more accurately if a pregnancy is indeed at high risk."

In the past, women were faced with the decision to have CVS earlier in the pregnancy but with a higher risk of miscarriage, or to wait until their second trimester for amniocentesis, which was thought to be safer but doesn't provide results until seve
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