Toshimitsu Masatake, Nagaoka Shinichi, Kobori Shuusaku, Ogawa Maki, Suzuki Fumihiko, Kato Takema, Miyai Shunsuke, Kawamura Rie, Inagaki Hidehito, Kurahashi Hiroki, Murotsuki Jun
Department of Maternal and Fetal Medicine, Miyagi Children's Hospital, Miyagi, Japan.
Division of Molecular Genetics, Institute for Comprehensive Medical Science, Fujita Health University, Toyoake, Japan.
Case Rep Obstet Gynecol. 2019 Oct 2;2019:6753184. doi: 10.1155/2019/6753184. eCollection 2019.
Fetal akinesia refers to a broad spectrum of disorders with reduced or absent fetal movements. There is no established approach for prenatal diagnosis of the cause of fetal akinesia. Chromosome 1p36 deletion syndrome is the most common subtelomeric terminal deletion syndrome, recognized postnatally from typical craniofacial features. However, the influence of chromosome 1p36 deletion on fetal movements remains unknown.
A 32-week-old fetus with akinesia showed multiple abnormalities, including fetal growth restriction, congenital cardiac defects, and ventriculomegaly. G-banding analysis using cultured amniocytes revealed 46,XY,22pstk+. Postnatal whole exome sequencing and subsequent chromosomal microarray identified a 3 Mb deletion of chromosomal region 1p36.33-p36.32. These results of molecular cytogenetic analyses were consistent with the fetal sonographic findings.
Using the exome-first approach, we identified a case with fetal akinesia associated with chromosome 1p36 deletion. Chromosome 1p36 deletion syndrome may be considered for differential diagnosis in cases of fetal akinesia with multiple abnormalities.
胎儿运动减少症指的是一系列胎儿活动减少或消失的病症。目前尚无针对胎儿运动减少症病因的产前诊断既定方法。1p36缺失综合征是最常见的亚端粒末端缺失综合征,在出生后通过典型的颅面部特征得以识别。然而,1p36缺失对胎儿运动的影响仍不清楚。
一名32周龄的运动减少胎儿表现出多种异常,包括胎儿生长受限、先天性心脏缺陷和脑室扩大。使用培养的羊膜细胞进行G显带分析显示为46,XY,22pstk+。产后全外显子测序及随后的染色体微阵列分析确定在染色体区域1p36.33 - p36.32存在3 Mb的缺失。这些分子细胞遗传学分析结果与胎儿超声检查结果一致。
采用外显子优先方法,我们鉴定出一例与1p36染色体缺失相关的胎儿运动减少症病例。对于伴有多种异常的胎儿运动减少症病例,在鉴别诊断时可考虑1p36缺失综合征。