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超声检查发现胎儿脑室扩张后行染色体微阵列分析对染色体异常的产前诊断。

Prenatal diagnosis of chromosomal aberrations by chromosomal microarray analysis in foetuses with ventriculomegaly.

机构信息

Department of Obstetrics and Gynaecology, West China Second University Hospital, Sichuan University, No. 20, Section 3, Renminnan Road, Chengdu, 610041, Sichuan, China.

Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.

出版信息

Sci Rep. 2020 Nov 27;10(1):20765. doi: 10.1038/s41598-020-77400-8.

Abstract

Ventriculomegaly is considered to be linked to abnormal neurodevelopment outcome. The aim of this retrospective study was to investigate the current applications of chromosomal microarray analysis (CMA) in foetuses with ventriculomegaly. A total of 548 foetuses with ventriculomegaly detected by prenatal ultrasound underwent single nucleotide polymorphism (SNP) array testing and were subjected to long-term follow-up. The overall prevalence of chromosomal aberrations was 7.30% (40/548), including 4.20% (23/548) with pathogenic/likely pathogenic copy number variants. The incidence of chromosomal aberrations was significantly higher in foetuses with bilateral ventriculomegaly than in those with unilateral ventriculomegaly (10.56% vs. 5.71%, P = 0.040), in foetuses with non-isolated ventriculomegaly than in those with isolated ventriculomegaly (12.99% vs. 2.38%, P < 0.0001), and in foetuses with severe ventriculomegaly than in those with mild-to-moderate ventriculomegaly (23.08% vs. 6.51%, P = 0.005). The outcome in foetuses with mild ventriculomegaly was significantly better than in those with moderate ventriculomegaly (95.60% vs. 84.00%, P = 0.003). Thus, CMA should be regarded as the first-tier test for prenatal diagnosis of foetal ventriculomegaly, especially in foetuses with bilateral or non-isolated ventriculomegaly. The outcome of foetuses with mild ventriculomegaly is favourable; however, there is an increased risk of neurodevelopmental disabilities in foetuses with moderate ventriculomegaly.

摘要

脑室扩大被认为与异常神经发育结局有关。本回顾性研究旨在探讨染色体微阵列分析(CMA)在脑室扩大胎儿中的当前应用。共有 548 例产前超声检查发现脑室扩大的胎儿接受了单核苷酸多态性(SNP)阵列检测,并进行了长期随访。染色体异常的总患病率为 7.30%(40/548),包括致病性/可能致病性拷贝数变异的 4.20%(23/548)。双侧脑室扩大胎儿的染色体异常发生率明显高于单侧脑室扩大胎儿(10.56%比 5.71%,P=0.040)、非孤立性脑室扩大胎儿高于孤立性脑室扩大胎儿(12.99%比 2.38%,P<0.0001)、重度脑室扩大胎儿高于轻度至中度脑室扩大胎儿(23.08%比 6.51%,P=0.005)。轻度脑室扩大胎儿的结局明显优于中度脑室扩大胎儿(95.60%比 84.00%,P=0.003)。因此,CMA 应被视为产前诊断胎儿脑室扩大的首选检测方法,特别是在双侧或非孤立性脑室扩大的胎儿中。轻度脑室扩大胎儿的结局良好,但中度脑室扩大胎儿有发生神经发育障碍的风险增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c83e/7699619/a61586ec1b4c/41598_2020_77400_Fig1_HTML.jpg

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