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胎儿产前诊断及 14q (14q31.3→q32.12)重复的分子细胞遗传学特征与异常母体血清生化指标相关。

Prenatal diagnosis and molecular cytogenetic characterization of a de novo interstitial duplication of 14q (14q31.3→q32.12) associated with abnormal maternal serum biochemistry.

机构信息

Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.

出版信息

Taiwan J Obstet Gynecol. 2013 Mar;52(1):125-8. doi: 10.1016/j.tjog.2012.08.002.

Abstract

OBJECTIVE

To present prenatal diagnosis and molecular cytogenetic characterization of a de novo interstitial duplication of 14q (14q31.3→q32.12) in a pregnancy associated with abnormal maternal serum biochemistry.

CASE REPORT

A 19-year-old woman underwent amniocentesis in the second trimester because of abnormal maternal serum biochemistry. Her husband was 33 years old. At 16 weeks of gestation, the levels of α-fetoprotein, unconjugated estriol, total β-human chorionic gonadotropin, and inhibin A were 0.8 multiples of median (MoM), 0.84 MoM, 3.06 MoM, and 1.14 MoM, respectively, consistent with a positive trisomy 21 risk of 1/269. Results of an amniocentesis revealed a small de novo interstitial duplication of 14q encompassing 14q31-q32.1. An array comparative genomic hybridization analysis detected a 6.6-Mb duplication at chromosome 14q31.3-q32.12. Results of a fluorescence in situ hybridization analysis showed a direct duplication of interstitial 14q. The karyotype was 46,XY,dup(14) (q31.3q32.12). Level II ultrasound was unremarkable. The parents decided to continue the pregnancy. A 3805-g healthy male baby was delivered at 39 weeks of gestation. When examined at 6 months of age, the neonate was normal in growth and psychomotor development with no apparent phenotypic abnormalities, although long-term follow-ups are required.

CONCLUSION

Abnormal maternal serum biochemistry in the second trimester may be a distinctive prenatal feature in pregnancy associated with fetal chromosome 14q duplication.

摘要

目的

介绍一例与母体血清生化异常相关的胎儿 14q 臂间重复(14q31.3→q32.12)的产前诊断和分子细胞遗传学特征。

病例报告

一位 19 岁的女性因母体血清生化异常而在孕中期接受羊膜穿刺术。她的丈夫 33 岁。在 16 周妊娠时,甲胎蛋白、未结合雌三醇、总β-人绒毛膜促性腺激素和抑制素 A 的水平分别为 0.8 中位数倍数(MoM)、0.84 MoM、3.06 MoM 和 1.14 MoM,符合三体 21 阳性风险 1/269。羊膜穿刺术结果显示,存在一个小的 14q 臂间重复,包含 14q31-q32.1。染色体微阵列比较基因组杂交分析检测到染色体 14q31.3-q32.12 存在一个 6.6-Mb 的重复。荧光原位杂交分析结果显示,14q 间区存在直接重复。核型为 46,XY,dup(14) (q31.3q32.12)。二级超声未见异常。父母决定继续妊娠。在孕 39 周时,一个 3805g 的健康男婴分娩。在 6 个月大时检查时,新生儿在生长和精神运动发育方面正常,没有明显的表型异常,尽管需要长期随访。

结论

母体血清生化异常可能是与胎儿 14q 重复相关的妊娠的一个独特的产前特征。

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