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21、18和13三体综合征高风险无创产前检测后的产前诊断:绒毛取样还是羊膜穿刺术?——英国一家区综合医院的经验

Prenatal diagnosis after high chance non-invasive prenatal testing for trisomies 21, 18 and 13, chorionic villus sampling or amniocentesis? - Experience at a district general hospital in the United Kingdom.

作者信息

Okoror Collins Ejakhianghe Maximilian, Arora Suruchi

机构信息

Department of Obstetrics and Gynaecology, Royal Berkshire Hospital, Craven road, Reading RG1 5AN, UK.

出版信息

Eur J Obstet Gynecol Reprod Biol X. 2023 Jul 1;19:100211. doi: 10.1016/j.eurox.2023.100211. eCollection 2023 Sep.

Abstract

The non-invasive prenatal testing (NIPT) analyses cell-free DNA (cfDNA) derived from the placental tissue in the maternal circulation. Though highly sensitive and specific, a major limitation is in cases of confined placental mosaicism (CPM). Whether to perform chorionic villus sampling (CVS) or amniocentesis to confirm a positive NIPT result is controversial. One major drawback of CVS is that cytogenetic diagnosis may not always reflect the true chromosomal make-up of the fetus. This work, therefore, proposes the use of amniocentesis in the presence of normal ultrasound findings, and the option of either CVS or amniocentesis when there are abnormal USS findings.

摘要

无创产前检测(NIPT)分析母体外周血循环中来自胎盘组织的游离DNA(cfDNA)。尽管NIPT具有高度敏感性和特异性,但一个主要局限在于存在局限性胎盘嵌合体(CPM)的情况。对于是否进行绒毛取样(CVS)或羊膜穿刺术以确认NIPT阳性结果存在争议。CVS的一个主要缺点是细胞遗传学诊断可能并不总是反映胎儿真正的染色体组成。因此,这项研究建议在超声检查结果正常时采用羊膜穿刺术,而当超声检查结果异常时则可选择CVS或羊膜穿刺术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33fe/10345242/48d98fe5f9be/gr1.jpg

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