Departments of Fetal Medicine and Ultrasound, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Ultrasound Obstet Gynecol. 2009 Dec;34(6):618-22. doi: 10.1002/uog.7468.
To evaluate whether high-resolution comparative genomic hybridization (HR-CGH) and subtelomeric and syndrome-specific multiplex ligation-dependent probe amplification (MLPA) would detect minor chromosomal aberrations in fetuses with increased nuchal translucency thickness (NT) and normal karyotype on conventional karyotyping.
Chorionic villus samples from 100 fetuses with NT > or = 99(th) percentile and normal G-banding analysis and MLPA for detection of aneuploidies for chromosomes 13, 18, 21, X and Y were included. Examinations were supplemented by HR-CGH and MLPA for syndromes and subtelomeric regions. Pregnancy outcome was followed up.
Among 80 liveborn children who were followed up, three (4%) had syndromes involving mental retardation, including a case of Sotos syndrome caused by a de novo mutation. 15% of fetuses were lost during pregnancy due to abnormalities and termination. The rate of adverse outcome overall was 18%. HR-CGH and MLPA did not detect any chromosomal aberrations associated with the syndromes.
The rate of adverse outcome was similar to levels recorded in the literature. Using CGH and MLPA did not increase the detection rate of genetic disease, which supports the current approach of repeated ultrasound examinations in these high-risk pregnancies.
评估高分辨率比较基因组杂交(HR-CGH)和端粒及综合征特异性多重连接依赖性探针扩增(MLPA)是否能检测到颈项透明层(NT)增厚且常规核型分析正常胎儿中的微小染色体异常。
对 100 例 NT 大于或等于第 99 百分位数且常规核型分析和 MLPA 均正常的胎儿进行绒毛取样。检查采用 HR-CGH 和 MLPA 检测染色体 13、18、21、X 和 Y 的非整倍体。对综合征和端粒区域进行补充检查。对妊娠结局进行随访。
在 80 例随访的活产儿中,有 3 例(4%)患有智力障碍相关的综合征,包括 1 例由新生突变引起的 Sotos 综合征。15%的胎儿因异常和终止妊娠而在孕期丢失。总的不良结局发生率为 18%。HR-CGH 和 MLPA 均未检测到与综合征相关的染色体异常。
不良结局的发生率与文献记录的水平相似。使用 CGH 和 MLPA 并未提高遗传疾病的检出率,这支持在这些高危妊娠中重复超声检查的当前方法。