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携带平衡易位 t(1;6)女性的遗传检测与妊娠结局的相关性研究。

Implication of Genetic Testing and Pregnancy Outcome in a Woman with Unbalanced Translocation t(1;6).

机构信息

Clinic of Medical Genetics and Prenatal Diagnostics, Children's Clinical University Hospital, Riga, Latvia.

Department of Biology and Microbiology, Rīga Stradiņš University, Riga, Latvia.

出版信息

Am J Case Rep. 2022 Feb 22;23:e935370. doi: 10.12659/AJCR.935370.

Abstract

BACKGROUND Parental chromosomal structural abnormalities can lead to diverse chromosomal imbalances at meiotic segregation during gametogenesis and subsequent early pregnancy loss or birth of a child with a chromosomal abnormality. The incidence of unbalanced translocations is 1 per 1000 newborns versus 3 per 1000 newborns for balanced rearrangements. Here, we present the case of a mother with an unbalanced chromosomal translocation and her offspring. CASE REPORT Our patient had a 1p36.31 duplication of 0.22 Mb and 6qter deletion of 1.2 Mb. She had 5 pregnancies with different outcomes. Her first child died 24 h after birth due to a congenital heart defect. Her second pregnancy resulted in the birth of a girl who was postnatally diagnosed with 1p36 deletion syndrome. The third and fourth pregnancies ended spontaneously in the first trimester. For her last pregnancy, the patient underwent a diagnostic amniocentesis at the 16th week of gestation. A large 5.4-Mb pathogenic duplication of 1p36.33 was detected in the fetus and the woman decided to terminate the pregnancy. CONCLUSIONS In this case report, we detail the different pregnancy outcomes induced by the mother's unbalanced chromosomal translocation and review the prenatal diagnostic genetic testing. Our report clearly demonstrates the complementary nature of chromosomal microarrays and conventional karyotyping.

摘要

背景

父母染色体结构异常可导致配子发生减数分裂过程中的染色体不平衡分离,继而导致早期妊娠丢失或生育染色体异常的患儿。不平衡易位的发生率为每 1000 例新生儿中有 1 例,平衡重排的发生率为每 1000 例新生儿中有 3 例。在此,我们介绍了一位携带不平衡染色体易位的母亲及其后代的病例。

病例报告

我们的患者携带 1p36.31 区 0.22Mb 的重复和 6qter 区 1.2Mb 的缺失。她经历了 5 次妊娠,结局各不相同。她的第一个孩子出生后 24 小时因先天性心脏病死亡。她的第二个孩子出生后被诊断患有 1p36 缺失综合征。第三个和第四个妊娠在孕早期自然流产。对于她的最后一次妊娠,患者在妊娠 16 周时接受了诊断性羊膜穿刺术。发现胎儿存在致病性的 1p36.33 区 5.4Mb 的大片段重复,患者决定终止妊娠。

结论

在本病例报告中,我们详细描述了由母亲的不平衡染色体易位引起的不同妊娠结局,并回顾了产前诊断遗传检测。我们的报告清楚地表明了染色体微阵列和传统核型分析的互补性。

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