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胎儿右位主动脉弓:相关异常、染色体微阵列分析的基因异常及出生后结局

Fetal right aortic arch: associated anomalies, genetic anomalies with chromosomal microarray analysis, and postnatal outcome.

作者信息

Peng Ruan, Xie Hong-Ning, Zheng Ju, Zhou Yi, Lin Mei-Fang

机构信息

Department of Ultrasonic Medicine, Fetal Medical Centre, Guangzhou, China.

Department of Obstetrics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

出版信息

Prenat Diagn. 2017 Apr;37(4):329-335. doi: 10.1002/pd.5015. Epub 2017 Mar 22.

Abstract

OBJECTIVES

The aim of the study was to assess the associated prenatal findings, genetic anomalies with chromosomal microarray analysis (CMA) and postnatal outcome of fetal right aortic arch (RAA).

METHODS

This retrospective study reviewed 92 fetuses diagnosed with RAA and the findings of CMA using Affymetrix CytoScan HD array in our institution between 2013 and 2016.

RESULTS

Postnatal data were not available for six cases, and genetic data were not available for 26 cases. Tetralogy of the Fallot was the most frequently associated anomaly. Among the 60 fetuses with known karyotype, one was 46, X, Yqh+, der(13)t(8;13)(q22.3;q33.2), one was 47, XYY and the remaining were normal. Our study showed that CMA could detect uncertain significant copy number variants in 5.2% of fetal RAA and pathogenic copy number variants in 5.2%, all of which were microdeletion in chromosome 22q11.21. The genetic anomalies, gestational age at delivery and postnatal death were not significantly different between RAA-no intracardiac anomalies and RAA-intracardiac anomalies group. One infant with aberrant left subclavian artery needed to perform a surgery for respiratory symptom.

CONCLUSIONS

A right aortic arch is associated with 22q11.2 deletion syndrome in approximately 5% of cases, and, therefore, prenatal testing, preferably using CMA, should be offered. © 2017 John Wiley & Sons, Ltd.

摘要

目的

本研究旨在评估胎儿右位主动脉弓(RAA)的相关产前检查结果、染色体微阵列分析(CMA)检测到的基因异常以及产后结局。

方法

本回顾性研究对2013年至2016年间在我院诊断为RAA并使用Affymetrix CytoScan HD阵列进行CMA检测的92例胎儿的检查结果进行了回顾。

结果

6例产后数据缺失,26例基因数据缺失。法洛四联症是最常见的相关异常。在60例已知核型的胎儿中,1例为46,X,Yqh+,der(13)t(8;13)(q22.3;q33.2),1例为47,XYY,其余核型正常。我们的研究表明,CMA可在5.2%的胎儿RAA中检测到不确定的意义重大的拷贝数变异,在5.2%的胎儿中检测到致病性拷贝数变异,所有变异均为22q11.21染色体微缺失。RAA无心脏内异常组与RAA有心脏内异常组在基因异常、分娩时孕周及产后死亡方面无显著差异。1例左锁骨下动脉异常的婴儿因呼吸症状需要进行手术。

结论

约5%的右位主动脉弓病例与22q11.2缺失综合征相关,因此应进行产前检测,最好使用CMA。© 2017 John Wiley & Sons, Ltd.

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