Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2013 Mar;76(3):153-7. doi: 10.1016/j.jcma.2012.11.002. Epub 2013 Jan 30.
Reciprocal translocation is the most common type of translocation; however, there are only a few studies that address the indications for reciprocal translocation in amniocentesis. Here we share our data, based on 30 years' experience in a single tertiary center, to investigate the rates and indications for amniocentesis in cases of reciprocal translocations.
A retrospective review of 16,749 pregnant women, who underwent midtrimester amniocentesis between January 1981 and December 2010, was conducted. Seventy-four cases of reciprocal translocation were identified.
The percentage of reciprocal translocations in all amniocentesis cases was 0.44% (74/16,749); of these 74 cases, 56 were balanced and 18 unbalanced. De novo abnormality occurred in 23 cases, which constituted 31.1% of all reciprocal translocations. The three major indications for amniocentesis with a diagnosis of reciprocal translocation included advanced maternal age (AMA, 52.7%), a parent with an abnormal karyotype (17.6%), and abnormal biochemical markers in the maternal serum (12.2%). For individual types of reciprocal translocations (balanced and unbalanced), except for the presence of abnormal biochemical markers in maternal serum, both AMA and a parent with an abnormal karyotype were primary indications for amniocentesis. However, the highest percentage of reciprocal translocations in all amniocentesis cases was found in cases involving a parent with an abnormal karyotype (5.16%, 13/252).
Patients with a parent who carries an abnormal karyotype should be encouraged to undergo amniocentesis in prenatal consultation, since the risk of a diagnosis of reciprocal translocation can be particularly high.
相互易位是最常见的易位类型;然而,仅有少数研究探讨了羊水穿刺中相互易位的适应证。在此,我们基于单一三级中心 30 年的经验,分享数据,以调查在相互易位病例中羊水穿刺的发生率和适应证。
对 1981 年 1 月至 2010 年 12 月期间进行的 16749 例中期羊水穿刺孕妇进行回顾性分析。共发现 74 例相互易位。
相互易位在所有羊水穿刺病例中的比例为 0.44%(74/16749);其中 56 例为平衡易位,18 例为不平衡易位。23 例新发异常,占所有相互易位的 31.1%。诊断为相互易位的羊水穿刺的三个主要适应证包括高龄产妇(52.7%)、父母一方染色体核型异常(17.6%)和母体血清生化标志物异常(12.2%)。对于个体类型的相互易位(平衡和不平衡),除母体血清生化标志物异常外,高龄产妇和父母一方染色体核型异常均为羊水穿刺的主要适应证。然而,在所有羊水穿刺病例中,涉及父母一方染色体核型异常的相互易位发生率最高(5.16%,13/252)。
在产前咨询中,应鼓励父母一方携带异常核型的患者进行羊水穿刺,因为诊断相互易位的风险可能特别高。