Vičić Ana, Hafner Tomislav, Bekavac Vlatković Ivanka, Korać Petra, Habek Dubravko, Stipoljev Feodora
Department of Obstetrics and Gynecology, Clinical Hospital "Sveti Duh", Zagreb, Croatia.
Department of Obstetrics and Gynecology, Clinical Hospital "Sveti Duh", Zagreb, Croatia.
Taiwan J Obstet Gynecol. 2017 Dec;56(6):731-735. doi: 10.1016/j.tjog.2017.10.004.
The aim of this study is to summarize the experience on prenatal diagnosis of Down syndrome.
The study includes a retrospective data analysis of 157 prenatally detected cases of Down syndrome, routinely diagnosed among 6448 prenatal investigations performed during a 13-year period (2002-2014) in a single tertiary center.
The prevalence of diagnosed Down syndrome cases was 2.4%. Maternal age alone was indication for prenatal diagnosis in 47 cases (45.2%), increased first-/second-trimester biochemical screening test in 34 cases (21.7%), abnormal ultrasound examination in 69 cases (43.9%), positive familial history for chromosomal abnormalities in four cases, and high risk for trisomy 21 revealed by cell-free DNA testing in three cases. Ultrasound anomalies were present in total of 94 fetuses (59.8%). The most common abnormality was cystic hygroma found in 46 cases (29.3%). A regular form of Down syndrome (trisomy 21) was found in 147 cases (93.6%), Robertsonian translocation in six cases (3.8%), and mosaic form in four cases (2.6%).
In prenatal diagnosis of Down syndrome noninvasive screening methods are important for estimation of individual risks, in both, young population of woman and older mothers, while conventional and molecular cytogenetic methods are essential for definite diagnosis and proper genetic counseling.
本研究旨在总结唐氏综合征产前诊断的经验。
本研究对157例产前检测出的唐氏综合征病例进行回顾性数据分析,这些病例是在一家三级中心13年期间(2002 - 2014年)进行的6448例产前检查中常规诊断出来的。
确诊的唐氏综合征病例患病率为2.4%。仅母亲年龄一项作为产前诊断指征的有47例(45.2%),孕早期/孕中期生化筛查结果升高的有34例(21.7%),超声检查异常的有69例(43.9%),有4例染色体异常家族史阳性,3例通过游离DNA检测显示21三体高风险。共有94例胎儿存在超声异常(59.8%)。最常见的异常是46例(29.3%)发现的囊性水瘤。147例(93.6%)为典型的唐氏综合征(21三体),6例(3.8%)为罗伯逊易位,4例(2.6%)为嵌合型。
在唐氏综合征的产前诊断中,无创筛查方法对于评估年轻女性和高龄孕妇的个体风险都很重要,而传统和分子细胞遗传学方法对于明确诊断和进行适当的遗传咨询至关重要。