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泰国孕妇中通过大动脉异常对迪乔治(22q11.2缺失)综合征进行产前筛查。

Prenatal screening of DiGeorge (22q11.2 deletion) syndrome by abnormalities of the great arteries among Thai pregnant women.

作者信息

Traisrisilp Kuntharee, Tongprasert Fuanglada, Srisupundit Kasemsri, Luewan Suchaya, Tongsong Theera

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

出版信息

Obstet Gynecol Sci. 2020 May;63(3):330-336. doi: 10.5468/ogs.2020.63.3.330. Epub 2020 Apr 14.

Abstract

OBJECTIVE

22q11.2DS (deletion syndrome) is one of the common serious anomalies resulting in high perinatal morbidity and mortality rate. Nevertheless, prenatal diagnosis of 22q11.2DS in Southeast Asia has never been described and its prevalence in prenatal series has never been explored. The objective of this study was to describe the experience of prenatal diagnosis of 22q11.2DS in the Thai population and to determine its prevalence among fetuses prenatally diagnosed with abnormalities of the great arteries.

METHODS

A prospective study was conducted on pregnant Thai women prenatally diagnosed with abnormalities of the great arteries in the second trimester. The recruited cases were investigated for fetal 22q11.2 deletion by in situ hybridization with a probe specific to the DiGeorge/VCFS TUPLE 1 region located on chromosome 22 for the locus D22S75, and 22qter for a telomere specific sequence clone as the control region.

RESULTS

Five out of the 42 (11.9%) fetuses with abnormalities of the great arteries meeting the inclusion criteria were proven to have 22q11.2DS. The most common abnormalities were the tetralogy of Fallot (or variants) and right-sided aortic arch, followed by a thymic hypoplasia.

CONCLUSION

As observed in the western countries, we have documented that, among pregnant Thai women, 22q11.2DS is highly prevalent in fetuses with abnormalities of the great arteries (approximately 12%). This information is important when counselling couples to undergo prenatal testing for 22q11.2DS, since this information is vital in the patients' decision of termination or continuation of pregnancy and in a well-prepared management of the affected child.

摘要

目的

22q11.2缺失综合征(22q11.2DS)是导致围产期高发病率和死亡率的常见严重异常之一。然而,东南亚地区22q11.2DS的产前诊断情况从未被描述过,其在产前系列研究中的患病率也从未被探讨过。本研究的目的是描述泰国人群中22q11.2DS的产前诊断经验,并确定其在产前诊断为大动脉异常的胎儿中的患病率。

方法

对妊娠中期产前诊断为大动脉异常的泰国孕妇进行前瞻性研究。通过用位于22号染色体上的DiGeorge/VCFS TUPLE 1区域特异性探针D22S75进行原位杂交,以及用端粒特异性序列克隆22qter作为对照区域,对纳入的病例进行胎儿22q11.2缺失检测。

结果

42例符合纳入标准的大动脉异常胎儿中,有5例(11.9%)被证实患有22q11.2DS。最常见的异常是法洛四联症(或变异型)和右侧主动脉弓,其次是胸腺发育不全。

结论

正如在西方国家所观察到的,我们记录到,在泰国孕妇中,22q11.2DS在大动脉异常的胎儿中高度流行(约12%)。当为夫妇提供22q11.2DS产前检测咨询时,这一信息很重要,因为这一信息对于患者决定终止或继续妊娠以及对患病儿童进行充分准备的管理至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8dbf/7231935/fb06970412c5/ogs-63-330-g001.jpg

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