Culture Failure Rates

· Culture failure rates:

· CVS and amnios:

· 2% failure rate

· Tissues (non-tumour):

· 37% (range 15-65%) overall failure rate for (non-tumour) solid tissue cultures (n=1257) (Rodgers et al, 1996)

· Skin:

1. 49% for skin (Rodgers et al, 1996)

2. 43% failure rate for skin after TOP (Rodgers et al, 1996)

3. 42% failure rate for skin after TOP (Kyle et al, 1996)

· POC:

1. 21% for POC (Rodgers et al, 1996)

2. 24% failure rate for other fetal parts (Rodgers et al, 1996)

· Cord / membranes:

1. 35% for cord / membranes (Rodgers et al, 1996)

· Placenta:

1. 19% failure rate for extra-fetal tissue (Rodgers et al, 1996)

2. 37% failure rate for placental tissue (Kyle et al, 1996)

· 1% failure rate for fetal tissue OR placental tissue (Bernick et al, 1998)

· Tissues that grow well:

1. Cord insertion

2. Fetal skin

3. Fetal cartilage

4. Fetal muscle

· Anectdotally, culture success rate seems to be higher for umbilical cord than fetal skin in our lab

· Categories of origin:

· Spontaneous abortion – 29% (Rodgers et al, 1996)

1. Skin – 50%

· TOP – 37% (Rodgers et al, 1996)

1. Skin – 43% (Rodgers et al, 1996)

2. Skin – 42% (Kyle et al, 1996)

3. Placenta – 37% (Kyle et al, 1996)

· Several authors have reported that karyotyping tissues after D&C risks:

1. Infectious contamination

2. Culture failure

3. Selective growth of maternal cells (Shulman et al, 1990)

· IUD:

1. < 28 wks – 57% (Rodgers et al, 1996)

2. > 28 wks – 63% (Rodgers et al, 1996)

3. Skin – 82% (Rodgers et al, 1996)

· Stillbirth – 43% (Rodgers et al, 1996)

1. Skin – 72% (Rodgers et al, 1996)

2. Karyotyping success is uniformly low after stillbirths (Kyle et al, 1996)

3. Even lower success in macerated specimens after D&C

· Neonatal death – 13% (Rodgers et al, 1996)

1. Skin – 15% (Rodgers et al, 1996)

· Live patient – 20% (Rodgers et al, 1996)

1. Skin – 17% (Rodgers et al, 1996)

· Transport:

· Dry:

1. Skin transported dry – 57% (Rodgers et al, 1996)

· Saline:

1. Skin transported in saline – 41% (Rodgers et al, 1996)

· Medium:

1. Skin transported in medium – 42% (Rodgers et al, 1996)

· Drug effects

· It has been suggested that exposure to prostaglandins may increase culture failure rate

· 47% failure rate for umbilical cord after intra-amniotic prostaglandin termination (Winsor et al, 2005)

· 10% failure rate for umbilical cord after vaginal misoprostol termination (Winsor et al, 2005)

· 17% failure rate for umbilical cord after oral misoprostol termination (Winsor et al, 2005)

· 27% failure rate following termination using vaginal prostaglandins (Kyle et al, 1996)

· 1% failure rate following termination by D&C (Bernick et al, 1998)

· No significant effect of intracardiac KCl (Kyle et al, 1996)

References:

· Barch MJ, Knutsen T, Spurbeck JL. The AGT Cytogenetics Laboratory Manual. 3rd ed. Lippincott Williams & Wilkins; 1997.

· Winsor EJT, Windrim R, Chitayat D, et al. Success rate for culture of fetal postmortem tissue is dependent on the method of pregnancy termination. Fetal Diagn Ther. 2005;20(4):306-8.

· Bernick BA, Ufberg DD, Nemiroff R, Donnenfeld A, Tolosa JE. Success rate of cytogenetic analysis at the time of second-trimester dilation and evacuation. Am J Obstet Gynecol. 1998;179(4):957-61.

· Rodgers CS, Creasy MR, Fitchett M, et al. Solid tissue culture for cytogenetic analysis: a collaborative survey for the Association of Clinical Cytogeneticists. J Clin Pathol. 1996;49(8):638-41.

· Kyle PM, Sepulveda W, Blunt S, et al. High failure rate of postmortem karyotyping after termination for fetal abnormality. Obstet Gynecol. 1996;88(5):859-62.