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Sha Y, Liu W, Hong J, Yang Y, Yu J, Fu X. A noninvasive method for the detection of foetal DNA in early pregnancy based on differential methylation pattern of Ras association domain family member 1A. J OBSTET GYNAECOL 2024; 44:2292611. [PMID: 38197583 DOI: 10.1080/01443615.2023.2292611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 12/04/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND The detection of foetal DNA and extravillus trophoblasts (EVTs) in early pregnancy in cervical and uterine samples offers a potential pathway for non-invasive prenatal diagnostics. However, the challenge lies in effectively quantifying these samples. This study introduces a novel approach using the Ras association domain family 1 A (RASSF1A), which exhibits hypermethylation in foetal cells and hypomethylation in maternal cells. The differential methylation pattern of RASSF1A provides a unique biomarker for quantifying foetal cells in cervical and intrauterine samples. METHODS This study was conducted between September 2022 and May 2023. In total, 23 samples (12 cervical cell samples and 11 intrauterine samples) were collected from women in the Sichuan Jinxin Women & Children Hospital, Jingxiu District, Chengdu, China. The cervical cell samples were collected via lavage and brush techniques, and the intrauterine cell samples were obtained via uterine lavage. These samples were collected as part of a broader effort to advance our understanding of foetal cell dynamics during early pregnancy. The sampling methods were chosen for their minimally invasive nature and their potential in capturing a representative cell population from the respective sites. After digestion of the cell samples using a methylation-sensitive restriction enzyme cocktail, a critical step to differentiate between maternal and foetal DNA, the quantitative polymerase chain reaction (qPCR) of RASSF1A and β-actin (ACTB) were employed to measure foetal DNA and cell concentrations. Immunofluorescence techniques targeting histocompatibility complex, class I G (HLA-G) and GATA binding protein 3 (GATA-3) were employed to detect EVTs in the cell samples and in decidual tissue, with the latter providing an additional layer of confirmation for the presence of foetal cells. RESULTS The results showed no hypermethylated RASSF1A was detected in any of the cervical samples, irrespective of whether the samples were obtained by brush or lavage. However, an average of 17,236 ± 7490 foetal cells per sample were detected in the uterine lavage samples. Foetal cells accounted for approximately 0.14% ± 0.10% of the total cell population in these samples. The presence of EVTs in these samples was confirmed by their expression of both HLA-G and GATA-3. CONCLUSION The detection of foetal cells in uterine cavity samples based on hypermethylation of RASSF1A and quantification of foetal cells can be used to prenatal screening. GATA-3 can be used to label EVTs.
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Affiliation(s)
- Yulin Sha
- Department of Obstetrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Sichuan Jinxin Xinan Women & Children Hospital (Jingxiu District), Chengdu, Sichuan, China
| | - Wei Liu
- Department of Obstetrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Sichuan Jinxin Xinan Women & Children Hospital (Jingxiu District), Chengdu, Sichuan, China
| | - Jiongzhi Hong
- Triplex International Biosciences (China) Co., LTD, Xiamen, Fujian, China
| | - Yan Yang
- Sichuan Jinxin Xinan Women & Children Hospital (Jingxiu District), Chengdu, Sichuan, China
| | - Jian Yu
- Sichuan Jinxin Xinan Women & Children Hospital (Jingxiu District), Chengdu, Sichuan, China
| | - Xiaodong Fu
- Department of Obstetrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
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Bourlard L, Manigart Y, Donner C, Smits G, Désir J, Migeotte I, Pichon B. Rarity of fetal cells in exocervical samples for noninvasive prenatal diagnosis. J Perinat Med 2022; 50:476-485. [PMID: 34973051 DOI: 10.1515/jpm-2021-0291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 12/04/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The possibility to isolate fetal cells from pregnant women cervical samples has been discussed for five decades but is not currently applied in clinical practice. This study aimed at offering prenatal genetic diagnosis from fetal cells obtained through noninvasive exocervical sampling and immuno-sorted based on expression of HLA-G. METHODS We first developed and validated robust protocols for cell detection and isolation on control cell lines expressing (JEG-3) or not (JAR) the HLA-G antigen, a specific marker for extravillous trophoblasts. We then applied these protocols to noninvasive exocervical samples collected from pregnant women between 6 and 14 weeks of gestational age. Sampling was performed through insertion and rotation of a brush at the ectocervix close to the external os of the endocervical canal. Finally, we attempted to detect and quantify trophoblasts in exocervical samples from pregnant women by ddPCR targeting the male SRY locus. RESULTS For immunohistochemistry, a strong specific signal for HLA-G was observed in the positive control cell line and for rare cells in exocervical samples, but only in non-fixative conditions. HLA-G positive cells diluted in HLA-G negative cells were isolated by flow cytometry or magnetic cell sorting. However, no HLA-G positive cells could be recovered from exocervical samples. SRY gene was detected by ddPCR in exocervical samples from male (50%) but also female (27%) pregnancies. CONCLUSIONS Our data suggest that trophoblasts are too rarely and inconstantly present in noninvasive exocervical samples to be reliably retrieved by standard immunoisolation techniques and therefore cannot replace the current practice for prenatal screening and diagnosis.
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Affiliation(s)
- Laura Bourlard
- Department of Medical Genetics, Erasme University Hospital, Bruxelles, Belgium.,Center of Human Genetics, Université Libre de Bruxelles - Erasme Hospital, Route de Lennik 808, 1070 Brussels, Belgium
| | - Yannick Manigart
- Department of Obstetrics and Gynecology, Saint-Pierre University Hospital, Bruxelles, Belgium
| | - Catherine Donner
- Department of Obstetrics and Gynecology, Erasme University Hospital, Bruxelles, Belgium
| | - Guillaume Smits
- Department of Medical Genetics, Erasme University Hospital, Bruxelles, Belgium.,Center of Human Genetics, Université Libre de Bruxelles - Erasme Hospital, Route de Lennik 808, 1070 Brussels, Belgium
| | - Julie Désir
- Department of Genetics, Institute of Pathology and Genetics (IPG), Gosselies, Belgium
| | - Isabelle Migeotte
- Department of Medical Genetics, Erasme University Hospital, Bruxelles, Belgium.,Center of Human Genetics, Université Libre de Bruxelles - Erasme Hospital, Route de Lennik 808, 1070 Brussels, Belgium
| | - Bruno Pichon
- Center of Human Genetics, Université Libre de Bruxelles - Erasme Hospital, Route de Lennik 808, 1070 Brussels, Belgium
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Abstract
Cell-free fetal DNA screening for Down syndrome has gained rapid acceptance over the past few years with increasing market penetration. Three main laboratory methodologies are currently used: a massive parallel shotgun sequencing (MPSS), a targeted massive parallel sequencing (t-MPS) and a single nucleotide polymorphism (SNP) based approach. Although each of these technologies has its own advantages and disadvantages, the performance of all was shown to be comparable and superior to that of traditional first-trimester screening for the detection of trisomy 21 in a routine prenatal population. Differences in performance were predominantly shown for chromosomal anomalies other than trisomy 21. Understanding the limitations and benefits of each technology is essential for proper counseling to patients. These technologies, as well as few investigational technologies described in this review, carry a great potential beyond screening for the common aneuploidies.
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Affiliation(s)
- Pe'er Dar
- Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center, Albert Einstein College of Medicine, 1695 Eastchester Road, Bronx, New York 10461, USA
| | - Hagit Shani
- Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center, Albert Einstein College of Medicine, 1695 Eastchester Road, Bronx, New York 10461, USA
| | - Mark I Evans
- Department of Obstetrics and Gynecology, Mt. Sinai School of Medicine, New York, NY, USA; Comprehensive Genetics and Fetal Medicine Foundation of America, 131 East 65th Street, New York, NY 10065, USA.
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Pfeifer I, Benachi A, Saker A, Bonnefont J, Mouawia H, Broncy L, Frydman R, Brival M, Lacour B, Dachez R, Paterlini-Bréchot P. Cervical trophoblasts for non-invasive single-cell genotyping and prenatal diagnosis. Placenta 2016; 37:56-60. [DOI: 10.1016/j.placenta.2015.11.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 11/03/2015] [Accepted: 11/05/2015] [Indexed: 11/27/2022]
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Mantzaris D, Cram DS. Potential of syncytiotrophoblasts isolated from the cervical mucus for early non-invasive prenatal diagnosis: Evidence of a vanishing twin. Clin Chim Acta 2015; 438:309-15. [DOI: 10.1016/j.cca.2014.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 08/25/2014] [Accepted: 09/02/2014] [Indexed: 02/06/2023]
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Bolnick JM, Kilburn BA, Bajpayee S, Reddy N, Jeelani R, Crone B, Simmerman N, Singh M, Diamond MP, Armant DR. Trophoblast retrieval and isolation from the cervix (TRIC) for noninvasive prenatal screening at 5 to 20 weeks of gestation. Fertil Steril 2014; 102:135-142.e6. [PMID: 24825422 PMCID: PMC10411519 DOI: 10.1016/j.fertnstert.2014.04.008] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Revised: 04/06/2014] [Accepted: 04/07/2014] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To use trophoblast cells accumulating in the endocervical canal at the beginning of pregnancy for noninvasive prenatal testing. DESIGN Prospective, double-blinded test for fetal gender. SETTING Academic medical center. PATIENT(S) Fifty-six women with singleton pregnancies at gestational age 5-20 weeks. INTERVENTION(S) Isolation of fetal cells from resident maternal cells in endocervical specimens using anti-human leukocyte antigen G coupled to magnetic nanoparticles; cell phenotyping immunofluorescently with a panel of trophoblast subtype-specific proteins; DNA integrity assessment with terminal dUTP nick-end labeling (TUNEL); and polymerase chain reaction (PCR) and fluorescent in situ hybridization (FISH) to detect sex chromosomes in individual cells. MAIN OUTCOME MEASURE(S) Trophoblast phenotype, TUNEL index, and percentage male cells. RESULT(S) The women were given a routine Papanicolaou test; fetal genders were verified from medical records. Recovery after immunomagnetic isolation averaged 746±59 cells across gestational age, with 99% expressing chorionic gonadotropin, whereas the depleted cell fraction expressed none. The isolated cells had an extravillous trophoblast phenotype and intact nuclear DNA (>95%). Fetal gender was determined in 20 specimens without error by PCR. The FISH analysis of isolated cells from male specimens validated their fetal origin. CONCLUSION(S) Noninvasive prenatal testing is feasible beginning at a gestational age of 5 weeks.
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Affiliation(s)
- Jay M Bolnick
- Department of Obstetrics and Gynecology, C. S. Mott Center for Human Growth and Development, Wayne State University, Detroit, Michigan
| | - Brian A Kilburn
- Department of Obstetrics and Gynecology, C. S. Mott Center for Human Growth and Development, Wayne State University, Detroit, Michigan
| | - Swati Bajpayee
- Department of Obstetrics and Gynecology, C. S. Mott Center for Human Growth and Development, Wayne State University, Detroit, Michigan
| | - Nitya Reddy
- Department of Obstetrics and Gynecology, C. S. Mott Center for Human Growth and Development, Wayne State University, Detroit, Michigan
| | - Roohi Jeelani
- Department of Obstetrics and Gynecology, C. S. Mott Center for Human Growth and Development, Wayne State University, Detroit, Michigan
| | - Barbara Crone
- Department of Obstetrics and Gynecology, C. S. Mott Center for Human Growth and Development, Wayne State University, Detroit, Michigan
| | - Neil Simmerman
- Department of Obstetrics and Gynecology, C. S. Mott Center for Human Growth and Development, Wayne State University, Detroit, Michigan
| | - Manivinder Singh
- Department of Obstetrics and Gynecology, C. S. Mott Center for Human Growth and Development, Wayne State University, Detroit, Michigan
| | - Michael P Diamond
- Department of Obstetrics and Gynecology, Georgia Regents University, Augusta, Georgia
| | - D Randall Armant
- Department of Obstetrics and Gynecology, C. S. Mott Center for Human Growth and Development, Wayne State University, Detroit, Michigan; Anatomy and Cell Biology, C.S. Mott Center for Human Growth and Development, Wayne State University, Detroit, Michigan; Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
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Gregg AR, Van den Veyver IB, Gross SJ, Madankumar R, Rink BD, Norton ME. Noninvasive prenatal screening by next-generation sequencing. Annu Rev Genomics Hum Genet 2014; 15:327-47. [PMID: 24849140 DOI: 10.1146/annurev-genom-090413-025341] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Noninvasive prenatal screening (NIPS) has emerged as a highly accurate method of screening for fetal Down syndrome, with a detection rate and specificity approaching 100%. Challenging the widespread use of this technology are cost and the paradigm shift in counseling that accompanies any emerging technology. The expense of the test is expected to decrease with increased utilization, and well beyond the current NIPS technology, its components (fetal genome measurements, sequencing technology, and bioinformatics) will be utilized alone or in combinations to interrogate the fetal genome. The end goal is simple: to offer patients information early in pregnancy about fetal genomes without incurring procedural risks. This will allow patients an opportunity to make informed reproductive and pregnancy management decisions based on precise fetal genomic information.
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Affiliation(s)
- Anthony R Gregg
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainesville, Florida 32610;
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Abstract
Looking for fetal cells and now nucleic acids has been the holy grail of prenatal diagnosis for more than a century. The use of noninvasive diagnostics has potential far beyond aneuploidy; in fact, its use for Rhesus disease is already commonplace in Europe. Accurate segregation of fetal cells from maternal cells or identification of cell-free fetal (cff) DNA or RNA is critical to the development of fetal cells as a screening or diagnostic prenatal technique. The large number of approaches that have been used is testimony to the fact that none of them have been particularly successful. This article discusses the current status and challenges of noninvasive prenatal diagnosis.
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Imudia AN, Kumar S, Diamond MP, DeCherney AH, Armant DR. Transcervical retrieval of fetal cells in the practice of modern medicine: a review of the current literature and future direction. Fertil Steril 2010; 93:1725-30. [PMID: 20056202 DOI: 10.1016/j.fertnstert.2009.11.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Revised: 11/05/2009] [Accepted: 11/10/2009] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To review published methods for transcervical collection of fetal cells and to assess the potential of this approach for application in prenatal diagnosis. MAIN OUTCOME MEASURE(S) Retrospective analysis of efforts at prenatal diagnosis with trophoblast cells shed into the lower uterine pole that accumulate within the cervical mucus at the level of the internal os. RESULT(S) Minimally invasive techniques that include cervical mucus aspiration, cervical swabbing, and cervical or intrauterine lavage can be used to retrieve trophoblast cells during the first trimester for diagnostic purposes, including for prenatal genetic analysis. Fetal cells have been identified in these specimens with success rates that vary from 40% to 90%. The disparity in reported success rates can be a function of gestational age, collection method, operator variability, detection sensitivity, or pregnancy status. Molecular approaches have been devised to determine fetal sex and identify aneuploidies. Antibody markers have proven useful to select trophoblast cells for genetic analysis and to demonstrate that the abundance of recoverable fetal cells diminishes in abnormal gestations, such as in ectopic pregnancy or blighted ovum. CONCLUSION(S) Transcervical collection of fetal cells offers several avenues for prenatal diagnosis that with further refinement could one day provide valuable information for the management of ongoing pregnancies.
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Affiliation(s)
- Anthony N Imudia
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI 48201-1405, USA
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Imudia AN, Suzuki Y, Kilburn BA, Yelian FD, Diamond MP, Romero R, Armant DR. Retrieval of trophoblast cells from the cervical canal for prediction of abnormal pregnancy: a pilot study. Hum Reprod 2009; 24:2086-92. [PMID: 19497946 DOI: 10.1093/humrep/dep206] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Fetal cells are shed from the regressing chorionic villi and it is possible to retrieve extravillous cytotrophoblast cells by transcervical sampling. The abundance of trophoblast cells in transcervical samples suggests that this non-invasive approach could distinguish between normal and abnormal pregnancies, such as an ectopic pregnancy (EP) and blighted ovum (BO). We aim to identify and quantify fetal trophoblast cells in the cervical canal during the first trimester to assess their usefulness to predict an abnormal pregnancy. METHODS Patients, age 18-45, presenting with a normal intrauterine pregnancy (IUP; n = 37), diagnosis of EP (n = 10) or BO (n = 5) were enrolled for collection of transcervical specimens using a cytobrush and fixative rinse. Non-pregnant, nulliparous women (n = 7) were included as negative controls. Cells were cleared of mucus by acidification, prepared on microscope slides and labeled with a monoclonal antibody recognizing the trophoblast marker, human leukocyte antigen (HLA)-G. HLA-G positive and negative cells were counted to calculate the ratio of trophoblast cells to total cervical cells. RESULTS Trophoblast cells were observed in 35/37 normal IUP, 6/10 EP and 4/5 BO specimens. The average frequency of HLA-G positive cells in the normal IUP cervical samples was approximately 1 in 2000, which was 4-fold higher than samples from patients with EP or BO (P < 0.001). Receiver operating characteristic analysis showed that EP and BO pregnancies were distinguishable from normal pregnancies with 93% sensitivity, 95% specificity, 97% positive predictive value and 87% negative predictive value. CONCLUSIONS This pilot study presents evidence that trophoblast cells can be reliably obtained and identified among cervical cells in the first trimester by immunohistochemical staining for HLA-G, and suggests for the first time that abnormal pregnancies may be predictable based on the abundance of trophoblast cells in the cervical canal.
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Affiliation(s)
- Anthony N Imudia
- Department of Obstetrics & Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
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Cioni R, Bussani C, Conti E, Buzzoni C, Bucciantini S, Mattei A, Scarselli G. The presence of trophoblastic cells in intrauterine lavage samples: lack of correlation with maternal and obstetric characteristics. Prenat Diagn 2008; 28:1064-7. [PMID: 18973152 DOI: 10.1002/pd.2131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To investigate the correlation between maternal, obstetric and sample characteristics and the quality (i.e. yield of trophoblastic cells) of intrauterine lavage (IUL) samples. METHODS We collected 202 IUL samples from women scheduled for first trimester termination of pregnancy (TOP). Trophoblastic cells were isolated from IUL samples and used for DNA analysis by a multiplex quantitative fluorescent polymerase chain reaction (QF-PCR) assay. A multivariate logistic regression analysis was performed, and a p<0.05 was considered statistically significant. RESULTS The presence of trophoblastic cells in IUL samples was documented in 151/202 cases (74.7%). Blood contamination of IULs was the only characteristic to positively correlate with the presence of trophoblasts (p=0.039; OR: 1.99; 95% CI: 1.03-3.82). CONCLUSIONS The correlation between the presence of contaminating blood and trophoblastic cells would indirectly confirm the hypothesis that IUL might act as a mini-CVS. The high yield rate of trophoblasts irrespective of maternal characteristics and past obstetric history would support the clinical use of this sampling technique, provided that its safety is clearly defined.
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Affiliation(s)
- Riccardo Cioni
- Department of Gynecology, Careggi University Hospital, Viale Morgagni 85, 50134 Florence, Italy.
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Bussani C, Cioni R, Mattei A, Fambrini M, Marchionni M, Scarselli G. Prenatal diagnosis of common aneuploidies in transcervical samples using quantitative fluorescent-PCR analysis. Mol Diagn Ther 2007; 11:117-21. [PMID: 17397248 DOI: 10.1007/bf03256231] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
AIM The aim of this study was to test the feasibility of diagnosing common fetal chromosomal aneuploidies using quantitative fluorescent (QF)-PCR on transcervical cell (TCC) samples collected in the first trimester of pregnancy by means of intrauterine lavage (IUL). METHODS A total of 181 TCC samples were retrieved from pregnant women between 5 and 12 weeks of gestation, immediately before elective termination of pregnancy, at which time corresponding placental tissue and maternal blood specimens were also obtained. Isolation of trophoblastic cells by micromanipulation was attempted in all TCC samples. Micromanipulated specimens were analyzed by multiplex QF-PCR, including short tandem repeats for the chromosomes X, Y, 21, 18, and 13. RESULTS The micromanipulation was successful in 152 of 181 cases (84.8%) where chorionic villous filaments and/or cell clumps of seeming trophoblastic origin could be isolated. All 152 samples were tested by QF-PCR analysis and peaks of paternal origin could be documented in all cases. Two cases of trisomy 21 and two cases of monosomy X0 were detected by means of QF-PCR assay, in accordance with the results obtained in corresponding placental samples. CONCLUSION This study provides evidence that the use of multiplex QF-PCR amplification of selected microsatellites could be applied to micromanipulated TCC samples and in particular to IUL samples, which often contain trophoblastic cells, for the detection of chromosomal aneuploidies. The approach described in this study appears, therefore, a very promising tool toward non-invasive prenatal genetic diagnosis in the early stage of gestation.
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Affiliation(s)
- Cecilia Bussani
- Department of Gynecology, Perinatology and Human Reproduction, University of Florence, Florence, Italy.
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Abstract
PURPOSE OF REVIEW For over a decade, methods of first-trimester, noninvasive prenatal genetic diagnosis have been actively pursued by many investigators. Isolation of fetal trophoblast from endocervical specimens remains an attractive approach, given the greater numbers of fetal cells than in maternal blood and the better potential for fetal-cell identification based on markers specific for a single cell type (trophoblasts). RECENT FINDINGS Current studies demonstrate feasibility in identification and molecular analysis of fetal trophoblast cells for prenatal genetic testing. Sampling methods involving lavage, cytobrush, or aspiration of cervical specimens, however, have limitations in the recovery of trophoblasts. SUMMARY Clinical applications await further systematic studies to determine safety and accuracy in recovery.
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Affiliation(s)
- Farideh Z Bischoff
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas 77030, USA.
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Katz-Jaffe MG, Mantzaris D, Cram DS. Transcervical cell sampling: a need for clear terminology. BJOG 2005. [DOI: 10.1111/j.1471-0528.2005.00776.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cioni R, Bussani C, Scarselli G. Transcervical cell sampling: a need for clear terminology. BJOG 2005; 112:1666-7; author reply 1667. [PMID: 16305574 DOI: 10.1111/j.1471-0528.2005.00774.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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