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原发性免疫缺陷病的产前诊断——印度情况概述

Prenatal Diagnosis for Primary Immunodeficiency Disorders-An Overview of the Indian Scenario.

作者信息

Yadav Reetika Malik, Gupta Maya, Dalvi Aparna, Bargir Umair Ahmed, Hule Gouri, Shabrish Snehal, Aluri Jahnavi, Kulkarni Manasi, Kambli Priyanka, Uppuluri Ramya, Seshadri Suresh, Jagadeesh Sujatha, Suresh Beena, Raja Jayarekha, Taur Prasad, Malaischamy Sivasankar, Ghosh Priyanka, Mahalingam Shweta, Kadam Priya, Lashkari Harsha Prasada, Tamhankar Parag, Tamhankar Vasundhara, Mithbawkar Shilpa, Bhattad Sagar, Jhawar Prerna, Makam Adinarayan, Bansal Vandana, Prasad Malathi, Govindaraj Geeta, Guhan Beena, Bharadwaj Tallapaka Karthik, Desai Mukesh, Raj Revathi, Madkaikar Manisha Rajan

机构信息

Center of Excellence for PIDs, Department of Pediatric Immunology and Leucocyte Biology, ICMR-National Institute of Immunohaematology, Mumbai, India.

Department of Pediatric Hematology-Oncology, Blood Marrow Transplantation, Apollo Hospitals, Chennai, India.

出版信息

Front Immunol. 2020 Dec 7;11:612316. doi: 10.3389/fimmu.2020.612316. eCollection 2020.

Abstract

Prenatal Diagnosis (PND) forms an important part of primary preventive management for families having a child affected with primary immunodeficiency. Although individually sparse, collectively this group of genetic disorders represents a significant burden of disease. This paper discusses the prenatal services available for affected families at various centers across the country and the challenges and ethical considerations associated with genetic counseling. Mutation detection in the index case and analysis of chorionic villous sampling or amniocentesis remain the preferred procedures for PND and phenotypic analysis of cordocentesis sample is reserved for families with well-characterized index case seeking PND in the latter part of the second trimester of pregnancy. A total of 112 families were provided PND services in the last decade and the presence of an affected fetus was confirmed in 32 families. Post-test genetic counseling enabled the affected families to make an informed decision about the current pregnancy.

摘要

产前诊断(PND)是对生育患有原发性免疫缺陷病患儿家庭进行一级预防管理的重要组成部分。虽然这类遗传性疾病个体发病率较低,但总体上却构成了重大的疾病负担。本文讨论了全国各中心为患病家庭提供的产前服务,以及与遗传咨询相关的挑战和伦理考量。对先证者进行突变检测以及对绒毛取样或羊水穿刺进行分析仍是产前诊断的首选方法,而对于在妊娠中期后期寻求产前诊断且先证者特征明确的家庭,脐带穿刺样本的表型分析则留作备用。在过去十年中,共有112个家庭接受了产前诊断服务,其中32个家庭被确诊怀有患病胎儿。检测后进行的遗传咨询使患病家庭能够就当前妊娠做出明智的决定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fd7/7750517/16fd2ea07d32/fimmu-11-612316-g001.jpg

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