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雄激素不敏感综合征的遗传咨询与产前诊断的初步研究:附3个家系报告

[Pilot study of genetic counseling and prenatal diagnosis in androgen insensitivity syndrome: with 3 families reports].

作者信息

Luo M, Jiang Y L, Yao F X, Tian Q J

机构信息

Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing 100730, China.

Medical Research Center, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2021 Apr 25;56(4):251-256. doi: 10.3760/cma.j.cn112141-20200817-00644.

DOI:10.3760/cma.j.cn112141-20200817-00644
PMID:33902236
Abstract

To explore genetic counseling and prenatal diagnosis strategies for women who have androgen insensitivity syndrome (AIS) family history or pregnancy history of AIS proband. Three families of complete AIS (CAIS) were retrospectively reported and summarized. The subsequent pregnancies and processes of prenatal diagnosis were followed up. Among three CAIS families, one family had androgen receptors (AR) gene mutation diagnosis; the other two families were diagnosed clinically without gene diagnosis. All three mothers of CAIS probands were in pregnant again when they sought counseling, with gestational weeks between 7-13 weeks. They underwent chorionic villi sampling or amniocentesis in their second trimester (at 12, 16, 17 weeks respectively). Chromosome gender of all three fetuses were 46,XY, which was inconsistent with the ultrasonographic phenotype of external genitalia. All patients chose selective abortion in their second trimester. The external genitalia of all aborted fetuses were female phenotype, which supported the diagnosis of CAIS. Genetic counseling and prenatal diagnosis should be provided to high-risk patients with family history of AIS or proband pregnancy history, so as to achieve the goal of good childbearing and sound childrearing.

摘要

探讨有雄激素不敏感综合征(AIS)家族史或AIS先证者妊娠史女性的遗传咨询及产前诊断策略。回顾性报道并总结3例完全性雄激素不敏感综合征(CAIS)家系。对后续妊娠及产前诊断过程进行随访。在3个CAIS家系中,1个家系进行了雄激素受体(AR)基因突变诊断;另外2个家系为临床诊断,未进行基因诊断。3例CAIS先证者的母亲在寻求咨询时均再次妊娠,孕周在7 - 13周之间。她们在孕中期(分别于12、16、17周)进行了绒毛取样或羊膜腔穿刺。3例胎儿的染色体性别均为46,XY,这与外生殖器的超声表型不符。所有患者均在孕中期选择了选择性流产。所有流产胎儿的外生殖器均为女性表型,支持CAIS的诊断。对于有AIS家族史或先证者妊娠史的高危患者,应提供遗传咨询和产前诊断,以实现优生优育的目标。

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