Hanif Misbah Iqbal, Khan Ayesha, Arif Afsheen, Shoeb Erum
Misbah Iqbal Hanif, MS. Department of Genetics, University of Karachi, Karachi, Pakistan.
Prof. Ayesha Khan, MBBS. MRCOG. FRCOG, Department of Gynecology and Obstetrics, Civil Hospital, Karachi, Pakistan.
Pak J Med Sci. 2019 Sep-Oct;35(5):1422-1427. doi: 10.12669/pjms.35.5.678.
BACKGROUND & OBJECTIVE: Spontaneous pregnancy loss has always been the frustrating experience for the couples and concern clinician. Chromosomal abnormality in either of the parent is considered to be the one of the leading cause of recurrent spontaneous miscarriages. This study was designed to evaluate the possible chromosomal etiology of miscarriage and the subsequent intimacy of maternal or paternal genetic abnormality.
This case-control study was conducted between January 2016 and October 2016 at a tertiary care hospital in Karachi. A total of thirty-two couples were selected who had suffered with recurrent spontaneous miscarriages (RSM). Using conventional cytogenetic technique karyotyping was performed on all of the subjects. For the control twenty couples were also selected with no history of pregnancy loss. All the karyotypes were recorded on the standard method. Data was analyzed through SPSS version 22.
Among thirty-two cases nine cases were found to have abnormal karyotype. In which sex chromosomal trisomy=02 (46,XY/47,XXY), marker chromosome=01 (47,XX,+mar), Robertsonian translocation=01 (45,XY,der,(14:21),(q10;q10)), reciprocal translocation=01 (46,XX,t(11;22)(q23;q11.2)), inversion=02 (46,XX,inv(9)(p11q13)) and minor structural abnormalities=02 (46,XX,15PS+) were found. Approximately equal ratio with 1:1.25 was observed among male and female carrier respectively. Non-significant difference was found between the ages of both carriers (p=0.34). Though a significant different value was calculated in the case of number of miscarriage (p=0.004*). Moreover, no significant association was found among spontaneous miscarriage (SM) and recurrent spontaneous miscarriage (RSM) with respect to maternal age (p= 0.157).
In the recent study possible chromosomal abnormalities suggested the evaluation of the patient with the history of recurrent spontaneous miscarriage must include conventional cytogenetic. Moreover, probe development and extended investigation can ease the prognosis among pregnancy related complication.
自然流产一直是困扰夫妻的经历,也是临床医生关注的问题。父母任何一方的染色体异常被认为是复发性自然流产的主要原因之一。本研究旨在评估流产可能的染色体病因以及母源或父源基因异常的后续情况。
本病例对照研究于2016年1月至2016年10月在卡拉奇的一家三级护理医院进行。共选取了32对患有复发性自然流产(RSM)的夫妇。对所有受试者采用传统细胞遗传学技术进行核型分析。作为对照,还选取了20对无流产史的夫妇。所有核型均按照标准方法记录。数据通过SPSS 22版进行分析。
在32例病例中,发现9例核型异常。其中性染色体三体=2例(46,XY/47,XXY),标记染色体=1例(47,XX,+mar),罗伯逊易位=1例(45,XY,der,(14:21),(q10;q10)),相互易位=1例(46,XX,t(11;22)(q23;q11.2)),倒位=2例(46,XX,inv(9)(p11q13)),微小结构异常=2例(46,XX,15PS+)。男性携带者和女性携带者的比例分别约为1:1.25。在两位携带者的年龄之间未发现显著差异(p=0.34)。不过,在流产次数方面计算出了显著差异值(p=0.004*)。此外,在自然流产(SM)和复发性自然流产(RSM)与母亲年龄之间未发现显著关联(p=0.157)。
在最近的研究中,可能的染色体异常表明,对有复发性自然流产病史的患者进行评估时必须包括传统细胞遗传学检查。此外,探针开发和进一步研究可以改善妊娠相关并发症的预后。