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对于产前检测到胎儿短长骨的病例,应进行染色体微阵列分析。

Chromosomal microarray should be performed for cases of fetal short long bones detected prenatally.

机构信息

Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St, Kfar Saba, Israel.

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Arch Gynecol Obstet. 2021 Jan;303(1):85-92. doi: 10.1007/s00404-020-05729-6. Epub 2020 Aug 6.

Abstract

PURPOSE

To investigate the prevalence of pathogenic and likely-pathogenic variants detected by chromosomal microarray analysis (CMA), among pregnancies with fetal short long bones diagnosed by ultrasound.

METHODS

The study cohort was based on cases of chromosomal microarray analyses performed nationwide for the indication of short long bones.

RESULTS

CMA was performed in 66 cases of short long bones. There were 4 cases with a pathogenic/likely pathogenic result (6%). The rate of chromosomal abnormalities was significantly higher compared to the background risk for copy number variations (CNVs) in pregnancies with no sonographic anomalies (P < 0.001). The yield of CMA in our cohort was significantly higher for both isolated and non-isolated cases, for cases in which the lowest estimated bone length percentile was above the 3rd percentile (below 5th percentile), and for cases diagnosed with short long bones after 22 weeks but not for cases diagnosed after 24 weeks.

CONCLUSION

The yield of CMA in cases with short long bones (both isolated and non-isolated) is significantly higher than the background risk for chromosomal anomalies in pregnancies with no sonographic anomalies. This suggests that CMA should be offered in pregnancies with a diagnosis of fetal short long bones.

摘要

目的

研究超声诊断胎儿四肢短小的病例中,通过染色体微阵列分析(CMA)检测到的致病性和可能致病性变异的发生率。

方法

本研究队列基于全国范围内因四肢短小而进行染色体微阵列分析的病例。

结果

对 66 例四肢短小的病例进行了 CMA 检测。其中有 4 例存在致病性/可能致病性结果(6%)。与无超声异常妊娠的拷贝数变异(CNV)的背景风险相比,染色体异常的发生率显著更高(P<0.001)。对于孤立性和非孤立性病例、最低估计骨长度百分位数高于第 3 百分位(低于第 5 百分位)的病例以及在 22 周后诊断为四肢短小的病例,CMA 的检出率均显著更高,但在 24 周后诊断为四肢短小的病例中则不然。

结论

在四肢短小(无论是孤立性还是非孤立性)的病例中,CMA 的检出率明显高于无超声异常妊娠的染色体异常的背景风险。这表明在诊断胎儿四肢短小的病例中,应提供 CMA 检测。

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