关键词: Chromosomal microarray analysis Genetic counseling Prenatal diagnosis Ultrasound anomalies

Mesh : Adult China Chromosome Aberrations / embryology statistics & numerical data Chromosome Disorders / diagnosis embryology Contraindications, Procedure Female Fetal Development / genetics Humans Maternal Serum Screening Tests / adverse effects Microarray Analysis / methods statistics & numerical data Pregnancy Retrospective Studies Risk Assessment Ultrasonography, Prenatal / statistics & numerical data

来  源:   DOI:10.1016/j.tjog.2021.01.008   PDF(Sci-hub)

Abstract:
OBJECTIVE: The present study aimed to determine the diagnostic value of prenatal chromosomal microarray analysis (CMA) for fetuses with several indications of being at high risk for various conditions.
METHODS: This retrospective analysis included 1256 pregnancies that were prenatally evaluated due to high-risk indications using invasive CMA. The indications for invasive prenatal diagnosis mainly included ultrasound anomalies, high-risk for maternal serum screening (MSS), high-risk for non-invasive prenatal tests (NIPT), family history of genetic disorders or birth defects, and advanced maternal age (AMA). The rate of clinically significant genomic imbalances between the different groups was compared.
RESULTS: The overall prenatal diagnostic yield was 98 (7.8%) of 1256 pregnancies. Clinically significant genomic aberrations were identified in 2 (1.5%) of 132 patients with non-structural ultrasound anomalies, 36 (12.7%) of 283 with structural ultrasound anomalies, 2 (4.5%) of 44 at high-risk for MSS, 38 (26.6%) of 143 at high-risk for NIPT, 11 (3.8%) of 288 with a family history, and 7 (2.1%) of 328 with AMA. Submicroscopic findings were identified in 29 fetuses, 19 of whom showed structural ultrasound anomalies.
CONCLUSIONS: The diagnostic yields of CMA for pregnancies with different indications greatly varied. CMA could serve as a first-tier test for structural anomalies, especially multiple anomalies, craniofacial dysplasia, urinary defects, and cardiac dysplasia. Our results have important implications for genetic counseling.
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