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通过绒毛取样和脐带穿刺术对甲型血友病进行产前诊断:全印度医学科学研究所的经验

Prenatal diagnosis of haemophilia A by chorionic villus sampling and cordocentesis: all India Institute of Medical Science experience.

作者信息

Ranjan R, Biswas A, Kannan M, Meena A, Deka D, Saxena R

机构信息

Department of Haematology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.

出版信息

Vox Sang. 2007 Jan;92(1):79-84. doi: 10.1111/j.1423-0410.2006.00851.x.

Abstract

BACKGROUND AND OBJECTIVE

We looked at the two most commonly used methods for prenatal diagnosis, cordocentesis and chorionic villus sampling for prenatal diagnosis of haemophilia A in an Indian setting.

MATERIAL AND METHODS

The study sample included 16 families which reported to us for prenatal diagnosis of haemophilia A at All India Institute of Medical Science, New Delhi, India. Prenatal tests were done on chorionic villus samples or on cord blood (cordocentesis). Molecular work-up included the use of indirect mutation analysis in the form of linkage markers like CA-13, CA-22, Xba1 and Bcl1 as well as direct mutation analysis in the form of inversion 1 and 22 detection. Non-molecular work-up included primarily factor VIII assays.

RESULT

Chorionic villus sampling was performed in eight mothers. Of the other eight mothers, six underwent cord blood factor VIII assays because these had absence of family history and were negative for linkage and inversion 1 and 22. One patient had a female child and another had a fetus that showed congenital abnormalities.

CONCLUSION

We found that the choice of either technique, chorionic villus or cordocentesis, is not really an alternative, but rather dependent on the gestational age of presentation.

摘要

背景与目的

我们研究了印度环境下用于甲型血友病产前诊断的两种最常用方法,即脐血穿刺术和绒毛取样术。

材料与方法

研究样本包括16个家庭,这些家庭前往印度新德里全印度医学科学研究所向我们咨询甲型血友病的产前诊断。对绒毛样本或脐血(脐血穿刺术)进行产前检测。分子检测包括使用连锁标记如CA - 13、CA - 22、Xba1和Bcl1等进行间接突变分析,以及进行倒位1和倒位22检测等直接突变分析。非分子检测主要包括凝血因子VIII检测。

结果

8名母亲接受了绒毛取样术。在其他8名母亲中,6名接受了脐血凝血因子VIII检测,因为她们没有家族病史且连锁分析以及倒位1和倒位22检测均为阴性。1名患者产下一名女婴,另一名患者的胎儿显示有先天性异常。

结论

我们发现,绒毛取样术或脐血穿刺术这两种技术的选择并非真正可相互替代,而是取决于就诊时的孕周。

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