CHORIONIC VILLUS SAMPLING FOR BETA-THALASSEMIA: THE FIRST REPORT OF EXPERIENCE IN IRAN

Author: Shahram Akhlaghpoor Novin Medical Radiation Institute, Medical Imaging

Objectives Beta-thalassemia is one of the most common hereditary disorders in Iran. The prenatal diagnosis
of beta-thalassemia is part of a control program in our country and it began 13 years ago. During the past
8 years the number of procedures has increased significantly as also the legal abortions. This is the first report
made on the CVS program in Iran.
Materials and Methods One thousand six hundred and sixty-one cases of transabdominal Chorionic Villus
Sampling (CVS) have been retrospectively evaluated. Among them 1381 cases had inclusion criteria. CVS
results, complications and fetal loss rate were evaluated. The distributions of the population at risk were divided
between eight regions that have been proposed for beta-thalassemia mapping previously.
Results The mean age of the patients was 26.2 ± 5.2 years with mean gestational age of 11.4 ± 1.4 weeks.
CVS was successful in all the patients (100%) although 1% required a second procedure. Post CVS fetal loss
was 1.45%. Other minor complications were bleeding or spotting (1.81%), amniotic fluid leak (0.5%), small
sub-chorionic hematoma (0.58%), severe abdominal pain (0.6%) and severe vasovagal reaction (0.14%). Late
complications were seen in 0.21% (oligohydraminos). Approximately 2/3 of the patients were referred from
three regions of the country, North (26.8%), South West (22.4%), Central (19.5%) and the remainder (31.3%)
were from the other five regions.
Conclusion CVS is a safe and effective method for prenatal diagnosis of beta-thalassemia in countries with
a high prevalence as in Iran. The overall complication rate is quite low and acceptable. Fortunately the recent
acceptance of legal abortion with respect to Muslim rules has increased the effectiveness of the procedure and
made great advances in its application in Iran. Correspondingly, social knowledge has also improved but still
there is a gap between the population at risk and the required prenatal diagnosis laboratories and sampling
centers.