1
|
Vankevičienė K, Matulevičienė A, Mazgelytė E, Paliulytė V, Vankevičienė R, Ramašauskaitė D. A Sporadic Case of COL1A1 Osteogenesis Imperfecta: From Prenatal Diagnosis to Outcomes in Infancy-Case Report and Literature Review. Genes (Basel) 2023; 14:2062. [PMID: 38003005 PMCID: PMC10671798 DOI: 10.3390/genes14112062] [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: 10/14/2023] [Revised: 11/03/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
Osteogenesis imperfecta (OI), also known as brittle bone disease, belongs to a rare heterogeneous group of inherited connective tissue disorders. In experienced prenatal centers, severe cases of OI can be suspected before birth from the first trimester prenatal ultrasound screening. In this article, we describe a case report of OI suspected at the 26th week of gestation and the patient's outcomes in infancy one year after birth, as well as compare our case to other prenatally or soon-after-birth suspected and/or diagnosed OI clinical case reports in the literature. This case was managed by a multidisciplinary team. In this clinical case, OI was first suspected when prenatal ultrasound revealed asymmetric intrauterine growth restriction and skeletal dysplasia features. The diagnosis was confirmed after birth using COL1A1 gene variant detection via exome sequencing; the COL1A1 gene variant causes OI types I-IV. The familial history was negative for both pregnancy-related risk factors and genetic diseases. At one year old, the patient's condition remains severe with bisphosphonate therapy.
Collapse
Affiliation(s)
- Karolina Vankevičienė
- Faculty of Medicine, Vilnius University, M. K. Čiurlionio Str. 21/27, LT-03101 Vilnius, Lithuania
| | - Aušra Matulevičienė
- Department of Human and Medical Genetics, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Santariskiu Str. 2, LT-08661 Vilnius, Lithuania;
| | - Eglė Mazgelytė
- Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, M. K. Čiurlionio Str. 21/27, LT-03101 Vilnius, Lithuania;
| | - Virginija Paliulytė
- Clinic of Obstetrics and Gynaecology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. Čiurlionio Str. 21/27, LT-03101 Vilnius, Lithuania;
| | - Ramunė Vankevičienė
- Clinic of Children’s Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. Čiurlionio Str. 21/27, LT-03101 Vilnius, Lithuania;
| | - Diana Ramašauskaitė
- Clinic of Obstetrics and Gynaecology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. Čiurlionio Str. 21/27, LT-03101 Vilnius, Lithuania;
| |
Collapse
|
2
|
Oelmeier K, Schmitz R, Dera I, Plaßmann M, Braun J, Willy D, Sourouni M, Köster HA, Steinhard J, Röpke A, Klockenbusch W, Möllers M. Congenital Limb Defects: A Retrospective Cohort Study and Overview of the Literature. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2023; 44:e241-e247. [PMID: 36198323 DOI: 10.1055/a-1926-7201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE Congenital limb defects are common malformations that are often associated with other organ defects and genetic disorders. Since prenatal detection is challenging and classification is often complex, the aim of this study was to describe a large cohort of fetuses with congenital limb defects and to identify characteristics that are essential for prenatal evaluation, counselling, and management. MATERIALS AND METHODS In this retrospective cohort study, all cases of confirmed fetal limb defects from two centers for prenatal ultrasound between 2001 and 2021 were evaluated. Cases with skeletal dysplasia were excluded from this study. Demographic data, association with genetic disorders, and correlation with maternal parameters were analyzed statistically. RESULTS 170 fetuses were included in this study. 60% were diagnosed with a reduction anomaly and 40% with a duplication anomaly. The majority of fetuses were male, and in 73.5% of all cases, additional malformations were present. Among the genetic causes, trisomy 13 and 18 were the most common in this cohort. CONCLUSION Congenital limb malformations are important markers for complex fetal disorders that warrant referral to specialists in prenatal ultrasound. To improve prenatal detection, care should be taken to visualize all fetal extremities already in early pregnancy.
Collapse
Affiliation(s)
- Kathrin Oelmeier
- Department of Gynecology and Obstetrics, University Hospital Munster, Munster, Germany
| | - Ralf Schmitz
- Department of Gynecology and Obstetrics, University Hospital Munster, Munster, Germany
| | - Izabela Dera
- Prenatal Medicine, Centre for Prenatal Medicine, Dortmund, Germany
| | - Margit Plaßmann
- Prenatal Medicine, Centre for Prenatal Medicine, Dortmund, Germany
| | - Janina Braun
- Department of Gynecology and Obstetrics, University Hospital Munster, Munster, Germany
| | - Daniela Willy
- Department of Gynecology and Obstetrics, University Hospital Munster, Munster, Germany
| | - Marina Sourouni
- Department of Gynecology and Obstetrics, University Hospital Munster, Munster, Germany
| | - Helen Ann Köster
- Department of Gynecology and Obstetrics, University Hospital Munster, Munster, Germany
| | - Johannes Steinhard
- Fetal Cardiology, Heart and Diabetes Center NRW Bad Oeynhausen, Bad Oeynhausen, Germany
- Prenatal Medicine and Human Genetics, Centre for Prenatal Medicine and Human Genetics, Munster, Germany
| | - Albrecht Röpke
- Insitute of Human Genetics, University Hospital Munster, Munster, Germany
| | - Walter Klockenbusch
- Department of Gynecology and Obstetrics, University Hospital Munster, Munster, Germany
| | - Mareike Möllers
- Department of Gynecology and Obstetrics, University Hospital Munster, Munster, Germany
| |
Collapse
|
3
|
Bilardo CM, Chaoui R, Hyett JA, Kagan KO, Karim JN, Papageorghiou AT, Poon LC, Salomon LJ, Syngelaki A, Nicolaides KH. ISUOG Practice Guidelines (updated): performance of 11-14-week ultrasound scan. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2023; 61:127-143. [PMID: 36594739 DOI: 10.1002/uog.26106] [Citation(s) in RCA: 37] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 10/24/2022] [Indexed: 05/27/2023]
Affiliation(s)
- C M Bilardo
- Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam UMC, University of Amsterdam, and Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - R Chaoui
- Center for Prenatal Diagnosis and Human Genetics, Berlin, Germany
| | - J A Hyett
- Western Sydney University, Sydney, Australia
| | - K O Kagan
- Department of Obstetrics and Gynecology, University of Tuebingen, Tuebingen, Germany
| | - J N Karim
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
| | | | - L C Poon
- Department of Obstetrics and Gynaecology, Chinese University of Hong Kong, Hong Kong SAR, China
| | - L J Salomon
- Department of Obstetrics and Fetal Medicine, Paris Cité University, Assistance Publique-Hopitaux de Paris, Hopital Necker-Enfants Malades, Paris, France
| | - A Syngelaki
- Fetal Medicine Research Institute, King's College Hospital, London, UK
| | - K H Nicolaides
- Fetal Medicine Research Institute, King's College Hospital, London, UK
| |
Collapse
|
4
|
Does isolated nuchal translucency from 2.5 to 2.9 mm increase the risk of fetal chromosome disease? Mol Genet Genomics 2022; 297:1643-1648. [PMID: 36056230 DOI: 10.1007/s00438-022-01948-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/19/2022] [Indexed: 10/14/2022]
Abstract
Increased fetal nuchal translucency (NT) is a common ultrasonic manifestation during pregnancy. Many studies have confirmed that NT ≥ 3 mm is a high risk factor for adverse pregnancy outcome. However, when NT is between 2.5 and 2.9 mm, will it increase the risk of fetal chromosome abnormalities and other diseases? What is the most appropriate method for prenatal chromosome evaluation? At present, it has not been widely reported in the literature, and the conclusion is also controversial. This prospective cohort study included fetal samples from women who underwent amniocentesis from 2017 to 2020. The samples of the experimental group were fetuses with NT ≥ 2.5 mm at 11 to 13 + 6 weeks of gestation, with or without ultrasonographic anomaly. The control group contained fetal NT < 2.5 mm without ultrasonographic anomalies. All amniotic fluid samples were tested by copy number variants sequencing. In 262 fetal samples with isolated NT from 2.5 to 2.9 mm, the detection rate of aneuploidy was 3.4% (9/262), and the risk of aneuploidy was significantly higher than that of the control group (1.4%, 32/2331) (relative risk 2.5, 95% CI 1.2-5.2). The detection rates of other pathogenic/likely pathogenic copy number variants in the two groups were 0.8% (2/262) and 1.3% (31/2331), respectively, which was not statistically significant (relative risk 0.6, 95% CI 0.1-2.4). Our results showed that isolated NT from 2.5 to 2.9 mm increased the risk of fetal chromosome aneuploidy. Therefore, noninvasive prenatal screening is recommended as the first choice for prenatal chromosome evaluation in this population.
Collapse
|
5
|
Kelley J, McGillivray G, Meagher S, Hui L. Increased nuchal translucency after low-risk noninvasive prenatal testing: What should we tell prospective parents? Prenat Diagn 2021; 41:1305-1315. [PMID: 34297420 DOI: 10.1002/pd.6024] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/08/2021] [Accepted: 07/21/2021] [Indexed: 12/15/2022]
Abstract
Three decades ago, the observation that first trimester fetuses with excess fluid accumulation at the back of the neck were more likely to be aneuploid, gave rise to a new era of prenatal screening. The nuchal translucency (NT) measurement in combination with serum biomarkers and maternal age, resulted in the first trimester combined screening (FTCS) program. The introduction of noninvasive prenatal testing (NIPT) over the past decade has introduced the option for parents to receive highly sensitive and specific screening information for common trisomy from as early as 10 weeks gestation, altering the traditional pathway FTCS pathway. The retention of the 11-13-week NT ultrasound remains important in the detection of structural anomalies; however, the optimal management of pregnancies with a low-risk NIPT result and an isolated increased NT measurement in an era of advanced genomic testing options is a new dilemma for clinicians. For parents, the prolonged period between the initial diagnosis in first trimester, and prognostic information at each successive stage of investigations up to 22-24 weeks, can be emotionally challenging. This article addresses the common questions from parents and clinicians as they navigate the uncertainty of having a fetus diagnosed with an increased NT after a low-risk NIPT result and presents suggested approaches to management.
Collapse
Affiliation(s)
- Joanne Kelley
- Department of Perinatal Medicine, Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - George McGillivray
- Department of Perinatal Medicine, Mercy Hospital for Women, Heidelberg, Victoria, Australia.,Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Simon Meagher
- Department of Perinatal Medicine, Mercy Hospital for Women, Heidelberg, Victoria, Australia.,Monash Ultrasound for Women, Monash IVF Group, Melbourne, Victoria, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia
| | - Lisa Hui
- Department of Perinatal Medicine, Mercy Hospital for Women, Heidelberg, Victoria, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|
6
|
AIUM Practice Parameter for the Performance of Detailed Diagnostic Obstetric Ultrasound Examinations Between 12 Weeks 0 Days and 13 Weeks 6 Days. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021; 40:E1-E16. [PMID: 32852128 DOI: 10.1002/jum.15477] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 06/11/2023]
|
7
|
Walczak-Sztulpa J, Wawrocka A, Leszczynska B, Mikulska B, Arts HH, Bukowska-Olech E, Daniel M, Krawczynski MR, Latos-Bielenska A, Obersztyn E. Prenatal genetic diagnosis of cranioectodermal dysplasia in a Polish family with compound heterozygous variants in WDR35. Am J Med Genet A 2020; 182:2417-2425. [PMID: 32804427 DOI: 10.1002/ajmg.a.61785] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/21/2020] [Accepted: 06/21/2020] [Indexed: 11/06/2022]
Abstract
The ciliary chondrodysplasias represent a group of clinically and genetically heterogeneous disorders that affect skeleton development. Cilia are organelles that project from the surface of many cell types and play an important role during prenatal and postnatal human development. Cranioectodermal dysplasia (Sensenbrenner syndrome, CED) is a ciliopathy primarily characterized by craniofacial, skeletal, and ectodermal abnormalities. To date six genes have been associated with CED: IFT122, WDR35, WDR19, IFT140, IFT43, and IFT52. Prenatal diagnosis of CED is challenging, and genetic testing can facilitate making a correct diagnosis. Here, we report on a family with two male siblings affected by CED: a 3.5 year-old patient and his 2 year-old brother. Molecular analysis of the proband at 1 year of age revealed compound heterozygous variants in WDR35: c.3G>A [p.(Met1-Ala30delinsMetfsTer4)] and c.2522A>T [p.(Asp841Val)]. Ultrasound examination during the second pregnancy revealed an increased nuchal translucency of 4.5 mm and a hypoplastic nasal bone at 12 weeks of gestation. Prenatal diagnostic testing was offered because of an increased risk for chromosomal abnormalities and recurrence risk for CED. Prenatal genetic analysis of a chorionic villus sample detected the WDR35 variants previously identified in the elder brother. This is the first report of a prenatal genetic diagnosis in CED.
Collapse
Affiliation(s)
| | - Anna Wawrocka
- Department of Medical Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Beata Leszczynska
- Department of Pediatric Nephrology, Medical University of Warsaw, Warsaw, Poland
| | - Boyana Mikulska
- Department of Obstetrics and Gynecology, Institute of Mother and Child, Warsaw, Poland
| | - Heleen H Arts
- Department of Pathology and Laboratory Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.,IWK Health Centre, Clinical Genomics Laboratory, Halifax, Nova Scotia, Canada
| | | | - Maria Daniel
- Department of Pediatric Nephrology, Medical University of Warsaw, Warsaw, Poland
| | - Maciej R Krawczynski
- Department of Medical Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Anna Latos-Bielenska
- Department of Medical Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Ewa Obersztyn
- Department of Medical Genetics, Institute of Mother and Child, Warsaw, Poland
| |
Collapse
|
8
|
Yan H, Zhu X, Chen J, Cao Y, Kwok YKY, Chen Z, Leung TY, Chen M, Choy KW. Noninvasive prenatal sequencing for multiple Mendelian monogenic disorders among fetuses with skeletal dysplasia or increased nuchal translucency. Prenat Diagn 2020; 40:1459-1465. [PMID: 32668031 DOI: 10.1002/pd.5792] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/19/2020] [Accepted: 07/12/2020] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To evaluate the performance of noninvasive prenatal sequencing for multiple Mendelian monogenic disorders (NIPS-M) among fetuses with skeletal abnormalities or increased nuchal translucency (NT). METHODS Pregnancies with fetal skeletal abnormalities or increased NT (≥3.0 mm) observed by ultrasonography were recruited between October 2017 and March 2019. Parental blood from 13 couples were collected for NIPS-M testing reported. All the NIPS-M results were followed up by invasive diagnostic testing or neonatal examination. RESULTS Among the 13 cases, 8 (61.5%) yielded positive results for pathogenic variants in the FGFR3, COL1A1, RAF1, PTPN11 and SOS1 genes by NIPS-M. One case was excluded for further analysis due to insufficient fetal DNA (<4.5%). De novo mutations were reported in six of the eight positive cases (75%). The other two were inconclusive as the pathogenic variants were detected in both plasma and genomic DNA of the mothers. The sensitivity of NIPS-M was 100%. CONCLUSIONS Our pilot study demonstrates that NIPS-M is an accurate approach for detection of multiple monogenic disorders among fetuses with skeletal abnormalities or increased NT. It serves as an alternative and highly sensitive method to provide valuable molecular information for these groups of women who are reluctant to undergo invasive procedure.
Collapse
Affiliation(s)
- Huanchen Yan
- Department of Fetal Medicine and Prenatal Diagnosis, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Obstetrics & Gynecology Institute of Guangzhou, Guangzhou, China
| | - Xiaofan Zhu
- Department of Obstetrics & Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China.,Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Jingsi Chen
- Department of Fetal Medicine and Prenatal Diagnosis, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Obstetrics & Gynecology Institute of Guangzhou, Guangzhou, China
| | - Ye Cao
- Department of Obstetrics & Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yvonne Ka Yin Kwok
- Department of Obstetrics & Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Zihan Chen
- Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Tak Yeung Leung
- Department of Obstetrics & Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China.,The Chinese University of Hong Kong-Baylor College of Medicine Joint Center for Medical Genetics, Hong Kong, China
| | - Min Chen
- Department of Fetal Medicine and Prenatal Diagnosis, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Obstetrics & Gynecology Institute of Guangzhou, Guangzhou, China
| | - Kwong Wai Choy
- Department of Obstetrics & Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China.,Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China.,The Chinese University of Hong Kong-Baylor College of Medicine Joint Center for Medical Genetics, Hong Kong, China
| |
Collapse
|
9
|
Beksac MS, Fadiloglu E, Unal C, Cetiner S, Tanacan A. 5-year experience of a tertiary center in major congenital abnormalities in singleton pregnancies. Birth Defects Res 2020; 112:633-639. [PMID: 31926058 DOI: 10.1002/bdr2.1645] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 12/11/2019] [Accepted: 12/26/2019] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To demonstrate major congenital abnormalities delivered or terminated at our institution between 2014 and 2018. MATERIALS AND METHODS Necessary information was retrieved from the registries of the delivery room and electronic database of Hacettepe University Hospital, Ankara. RESULTS This study was consisted of 307 major congenital anomalies. The incidence of major congenital anomalies was 2.9 per 1,000 live births, while the majority of the cases were related to cardiovascular, central nervous system, and diaphragmatic hernia with 97, 87, and 25 cases at each group, respectively. Rate of termination of pregnancy (TOP) and live birth were 35.1 and 59.2%, respectively. The overall infant mortality rate was 28.9% in cases with live birth, while this rate was highest in cardiovascular system abnormalities and diaphragmatic hernia. Out of 182 newborns, 92.8% admitted to the neonatal intensive care unit after the delivery. Median gestational week at TOP was 21(20). CONCLUSION We have shown that TOP and infant mortality rates were 35.1 and 28.9%, respectively in pregnancies with fetal malformations. Detailed multidisciplinary counseling must be provided for parents in pregnancies with major congenital abnormalities.
Collapse
Affiliation(s)
- M Sinan Beksac
- Division of Perinatology, Department of Obstetrics and Gynecology, Hacettepe University, Ankara, Turkey
| | - Erdem Fadiloglu
- Division of Perinatology, Department of Obstetrics and Gynecology, Hacettepe University, Ankara, Turkey
| | - Canan Unal
- Division of Perinatology, Department of Obstetrics and Gynecology, Hacettepe University, Ankara, Turkey
| | - Sibel Cetiner
- Division of Perinatology, Department of Obstetrics and Gynecology, Hacettepe University, Ankara, Turkey
| | - Atakan Tanacan
- Division of Perinatology, Department of Obstetrics and Gynecology, Hacettepe University, Ankara, Turkey
| |
Collapse
|
10
|
Houdayer C, Ziegler A, Boussion F, Blesson S, Bris C, Toutain A, Biquard F, Guichet A, Bonneau D, Colin E. Prenatal diagnosis of Desbuquois dysplasia type 1 by whole exome sequencing before the occurrence of specific ultrasound signs. J Matern Fetal Neonatal Med 2019; 34:2217-2220. [PMID: 31510824 DOI: 10.1080/14767058.2019.1657084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Desbuquois dysplasia is a very severe and sometimes lethal form of osteochondrodysplasia characterized by prenatal onset of severe micromelic short stature, joint laxity with multiple joint dislocations, specific radiographic features, and facial dysmorphism. Here, we report a case for which whole exome sequencing allowed early prenatal diagnosis of Desbuquois dysplasia before the detection of characteristic ultrasound signs of the disease.
Collapse
Affiliation(s)
- Clara Houdayer
- Department of Biochemistry and Genetics, Angers University Hospital, Angers, France
| | - Alban Ziegler
- Department of Biochemistry and Genetics, Angers University Hospital, Angers, France
| | - Françoise Boussion
- Department of Obstetrics and Gynecology, Angers University Hospital, Angers, France
| | - Sophie Blesson
- Department of Genetics, Tours University Hospital, Tours, France
| | - Céline Bris
- Department of Biochemistry and Genetics, Angers University Hospital, Angers, France
| | - Annick Toutain
- Department of Genetics, Tours University Hospital, Tours, France
| | - Florence Biquard
- Department of Obstetrics and Gynecology, Angers University Hospital, Angers, France
| | - Agnès Guichet
- Department of Biochemistry and Genetics, Angers University Hospital, Angers, France
| | - Dominique Bonneau
- Department of Biochemistry and Genetics, Angers University Hospital, Angers, France.,Mitovasc, UMR CNRS 6015, INSERM U1083, Angers University, Angers, France
| | - Estelle Colin
- Department of Biochemistry and Genetics, Angers University Hospital, Angers, France.,Mitovasc, UMR CNRS 6015, INSERM U1083, Angers University, Angers, France
| |
Collapse
|
11
|
Prenatal Diagnosis of Osteogenesis Imperfecta Type III. J Obstet Gynaecol India 2019; 69:374-376. [DOI: 10.1007/s13224-019-01230-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 04/09/2019] [Indexed: 10/27/2022] Open
|
12
|
Pajkrt E, Chitty LS. A sonographic approach to the prenatal diagnosis of skeletal dysplasias. Prenat Diagn 2019; 39:701-719. [DOI: 10.1002/pd.5501] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 05/18/2019] [Accepted: 06/01/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Eva Pajkrt
- Academic Medical Centre, Department of Obstetrics Amsterdam The Netherlands
| | - Lyn S. Chitty
- Great Ormond Street NHS Foundation Trust and the UCL Great Ormond Street Institute of Child Health London UK
| |
Collapse
|
13
|
Tan AP, Priego G. Thanatophoric dysplasia type 1 with tectal plate dysplasia and aqueductal stenosis. Childs Nerv Syst 2019; 35:1059-1061. [PMID: 30610483 DOI: 10.1007/s00381-018-04035-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 12/17/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Skeletal dysplasias are a heterogeneous group of disorders comprising of more than 300 entities, many of which manifest in the prenatal period, emphasizing the importance of accurate prenatal diagnosis. Detection of a lethal skeletal dysplasia via prenatal ultrasound is often straightforward. However, establishing the specific diagnosis and detailed evaluation of intracranial anomalies are often challenging. Fetal magnetic resonance imaging (MRI) is superior to ultrasound in the detection of abnormal sulcation pattern, corpus callosal agenesis, and posterior fossa anomalies. Hence, it has the potential of delineating neuroimaging features that may not be fully elucidated by ultrasound. The objective of this article is to describe an unusual case of thanatophoric dysplasia (TD) with dysplastic tectal plate and resultant aqueductal stenosis diagnosed on fetal MRI. To the best of our knowledge, this has never been reported before in the literature. A comprehensive review of literature pertaining to TD-associated CNS abnormalities will also be included. CONCLUSIONS Our reported case adds to the current limited knowledge of this rare entity and emphasizes the crucial role of fetal MRI in expanding the neuroimaging phenotypes of TD.
Collapse
Affiliation(s)
- Ai Peng Tan
- Department of Diagnostic Imaging, National University Health System, 1E Kent Ridge Rd, Singapore, 119228, Singapore.
| | - Gema Priego
- Department of Radiology, Queen's Hospital, Rom Valley Way, Romford, RM7 0AG, UK
| |
Collapse
|
14
|
Yolanda N, Yulianto F, Arina S, Edwin J. A full-term infant with type II thanatophoric dysplasia. CASE REPORTS IN PERINATAL MEDICINE 2019. [DOI: 10.1515/crpm-2018-0035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Objectives
To report a neonate with clinical findings consistent with thanatophoric dysplasia (TD). Only a few cases of this rare and lethal skeletal disorder have been reported in South-East Asia.
Case presentation
A 37-year-old Asian female, fourth gravida at 39 weeks, presented to our hospital for an elective cesarean section due to polyhydramnios, frank breech and gestational hypertension. The father was a 42-year-old Asian male. There was no history of rashes, fever, alcohol intake, substance drug abuse, smoking habit or radiation exposure. Ultrasound (US) of 34-weeks’ gestation found a baby with frontal bossing, prominent temporal lobe, clover-skull and low nasal bridge. The thoracic diameter was smaller than the abdominal diameter. Short limbs without bowing were noted in femur and humeral bones. The patient delivered a baby boy, 4115 g, APGAR scores were 5 and 7 at 1 and 5 min. The baby had a dysmorphic face, frontal bossing, low nasal bridge, low-set ears and short neck. The thorax was narrow and abdomen was protuberant. The upper and lower proximal limbs appeared short. A chest X-ray revealed short, curved ribs and opacification of both lungs. He had respiratory distress shortly after birth and had persistent severe respiratory distress despite adequate mechanical ventilation. On the third day, he had cardiac arrest; resuscitation was not done due to family request. The baby was declared deceased due to cardiopulmonary failure related to his congenital anomaly.
Conclusions
Ultrasonography could readily indicate TD prenatally. The pregnancy can continue up to late third trimester without miscarriage. Most of the neonates die in utero; those who survive are dependent on ventilator.
Collapse
Affiliation(s)
- Natharina Yolanda
- Bunda Aliyah Maternity Hospital , Jl. Pahlawan Revolusi No 100 , Pondok Bambu, Jakarta Timur , Indonesia , Tel.: +6282122009982
| | | | - Sally Arina
- Bunda Aliyah Maternity Hospital , Jakarta , Indonesia
| | - Johanes Edwin
- Department of Child Health , Bunda Aliyah Maternity Hospital , Jakarta , Indonesia
| |
Collapse
|
15
|
Ren Y, Zhao J, Li R, Xie Y, Jiang S, Zhou H, Liu H, You Y, Chen F, Wang W, Gao Y, Meng Y, Lu Y. Noninvasive prenatal test for FGFR3-related skeletal dysplasia based on next-generation sequencing and plasma cell-free DNA: Test performance analysis and feasibility exploration. Prenat Diagn 2018; 38:821-828. [PMID: 30048571 DOI: 10.1002/pd.5334] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 07/13/2018] [Accepted: 07/14/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To explore the feasibility and accuracy of a noninvasive prenatal test for fibroblast growth factor receptor 3 (FGFR3)-related skeletal dysplasia based on next-generation sequencing (NGS) of plasma cell-free DNA. METHOD Fragmented genome DNA (gDNA) of fetuses with achondroplasia (ACH) and thanatophoric dysplasia type I (TD I) was mixed with postdelivery maternal plasma cell-free DNA to generate spiked samples of different modeled fetal fractions. Multiplex polymerase chain reaction was used to amplify the 19 FGFR3 loci, and the amplification products were then sequenced by NGS to detect the fetal mutant alleles. Then, maternal plasma samples of pregnant women carrying ACH (n = 4) and TD I fetuses (n = 2), as well as healthy controls (n = 15), were tested by NGS, and the test performance was evaluated. RESULTS Fetal FGFR3 mutations were detected in all artificial mixtures with fetal gDNA concentrations above 3%. In clinical validation, our method identified all fetal FGFR3 mutant alleles from maternal plasma, with no false positive results. The sensitivity and specificity of our method were 100% (95% CI, 54.1%-100%) and 100% (78.2%-100%), respectively. CONCLUSION Our method had a favorable performance for noninvasively detecting fetal FGFR3 mutations in maternal plasma, highlighting its promising value in developing a noninvasive prenatal test for de novo and paternally inherited disorders.
Collapse
Affiliation(s)
- Yuan Ren
- Department of Obstetrics and Gynecology, Chinese PLA General Hospital, Beijing, China
| | - Jia Zhao
- BGI-Shenzhen, Shenzhen, China.,China National GeneBank, BGI-Shenzhen, Shenzhen, China
| | - Ruibing Li
- Department of Obstetrics and Gynecology, Chinese PLA General Hospital, Beijing, China
| | | | - Shufang Jiang
- Department of Obstetrics and Gynecology, Chinese PLA General Hospital, Beijing, China
| | - Honghui Zhou
- Department of Obstetrics and Gynecology, Chinese PLA General Hospital, Beijing, China
| | | | - Yanqin You
- Department of Obstetrics and Gynecology, Chinese PLA General Hospital, Beijing, China
| | - Fang Chen
- BGI-Shenzhen, Shenzhen, China.,China National GeneBank, BGI-Shenzhen, Shenzhen, China.,Laboratory of Genomics and Molecular Biomedicine, Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | | | - Ya Gao
- BGI-Shenzhen, Shenzhen, China.,China National GeneBank, BGI-Shenzhen, Shenzhen, China
| | - Yuanguang Meng
- Department of Obstetrics and Gynecology, Chinese PLA General Hospital, Beijing, China
| | - Yanping Lu
- Department of Obstetrics and Gynecology, Chinese PLA General Hospital, Beijing, China
| |
Collapse
|
16
|
Zhou X, Chandler N, Deng L, Zhou J, Yuan M, Sun L. Prenatal diagnosis of skeletal dysplasias using a targeted skeletal gene panel. Prenat Diagn 2018; 38:692-699. [PMID: 29907962 DOI: 10.1002/pd.5298] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 05/24/2018] [Accepted: 05/31/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVE This study aimed to perform an accurate and precise diagnosis for fetuses with suspected skeletal anomalies based on an incomplete and limited ultrasound phenotype. METHODS Proband-only targeted skeletal gene panel sequencing was performed on 12 families who had fetuses with suspected skeletal anomalies based on ultrasound evaluations at a mean gestational age of 24 weeks and 3 days. The fetuses all had normal standard genetic testing yield (karyotyping and microarray). RESULTS In 10 of 12 fetuses, panel sequencing provided a diagnosis or possible diagnosis with identification of variants in the following genes: FGFR3, COL1A2, IHH, COL2A1, and DYNC2H1. Two cases revealed novel variants in COL2A1 and DYNC2H1. CONCLUSIONS Our study suggests that targeted skeletal gene panel sequencing is highly sensitive for prenatal diagnosis of fetuses presenting with unexpected ultrasound findings suggestive of a skeletal dysplasia.
Collapse
Affiliation(s)
- Xinyao Zhou
- Unit of Fetal Medicine, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, P.R. China
| | - Natalie Chandler
- North East Thames Regional Genetics Laboratory, Great Ormond Street NHS Foundation Trust, London, UK
| | - Linbei Deng
- Unit of Fetal Medicine, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, P.R. China
| | - Jia Zhou
- Unit of Fetal Medicine, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, P.R. China
| | - Meizhen Yuan
- Unit of Fetal Medicine, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, P.R. China
| | - Luming Sun
- Unit of Fetal Medicine, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, P.R. China
| |
Collapse
|
17
|
|
18
|
Sharony R, Engel O, Litz-Philipsborn S, Sukenik-Halevy R, Biron-Shental T, Evans MI. The impact of third-trimester genetic counseling. Arch Gynecol Obstet 2018; 297:659-665. [PMID: 29306968 DOI: 10.1007/s00404-017-4638-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 12/19/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the impact of genetic counseling (GC) during the third trimester by analyzing changes in pregnancy management and the correlation with postnatal findings. METHODS This was a retrospective study. Pregnancy course and neonatal follow-up were analyzed according to the reason for referral and implementation of recommendations. RESULTS The records of neonates born to 181 women were retrieved. Fifty-two women (group 1-29%) qualified for pregnancy termination under Israeli guidelines and laws, and 129 (group 2-71%) were not at the time they were referred. By another division: 104 women (group 3-57%) followed the physician's diagnostic recommendations completely after counseling including amniocentesis, fetal MRI, targeted ultrasound scans, fetal echocardiography. Seventy-seven declined amniocentesis (group 4-43%). Additional abnormalities were detected postpartum in all groups without statistically difference: 3/52 (10%) in group 1, 9/129 (7%) in group 2, 6/104 (6%) in group 3, and 6/77 (8%) in group 4). CONCLUSION GC in the third trimester of pregnancy provided the couple with a sharper more focused picture and assisted them to perceive the significance of new, significant fetal findings which attest to the value of the GC.
Collapse
Affiliation(s)
- Reuven Sharony
- The Genetics Institute, Meir Medical Center, Kfar Saba, Israel. .,Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St., 44281, Kfar Saba, Israel. .,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Offra Engel
- Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St., 44281, Kfar Saba, Israel
| | | | - Rivka Sukenik-Halevy
- The Genetics Institute, Meir Medical Center, Kfar Saba, Israel.,Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St., 44281, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tal Biron-Shental
- Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St., 44281, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Mark I Evans
- Department of Obstetrics and Gynecology, Fetal Medicine Foundation of America, Comprehensive Genetics PLLC, Mt. Sinai School of Medicine, New York, USA
| |
Collapse
|
19
|
Antony D, Nampoory N, Bacchelli C, Melhem M, Wu K, James CT, Beales PL, Hubank M, Thomas D, Mashankar A, Behbehani K, Schmidts M, Alsmadi O. Exome sequencing for the differential diagnosis of ciliary chondrodysplasias: Example of a WDR35 mutation case and review of the literature. Eur J Med Genet 2017; 60:658-666. [DOI: 10.1016/j.ejmg.2017.08.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 08/17/2017] [Accepted: 08/29/2017] [Indexed: 12/30/2022]
|
20
|
Bondioni MP, Pazzaglia UE, Izzi C, Di Gaetano G, Laffranchi F, Baldi M, Prefumo F. Comparative X-ray morphometry of prenatal osteogenesis imperfecta type 2 and thanatophoric dysplasia: a contribution to prenatal differential diagnosis. Radiol Med 2017; 122:880-891. [PMID: 28674909 DOI: 10.1007/s11547-017-0784-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 06/16/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The purpose of the paper was to assess the morphometric parameters to improve the specificity of the ultrasound (US) signs for the early differential diagnosis between two lethal dysplasias, as thanatophoric dysplasia (TD) and osteogenesis imperfecta type 2 (OI-2). METHOD The diaphyseal length and the bowed shape of long bones associated with vertebral body dimension assessment were investigated in a group of 14 pregnancy terminations carried out in the time period 2007-2013. The definitive diagnosis was established after pregnancy termination by means of skeletal standardized X-rays, histopathology and gene analysis. RESULTS TD and OI-2 long bones were significantly shorter than controls. No significant differences were observed between the two dysplasias. The bowing angle was higher in OI-2; a true angulation or eventually axial displacement was present only in the latter. Furthermore, they did not show any evidence of vertebral collapse. The thanatophoric dysplasia presented less bowed long bones, and never true angulation. The spine was steadily characterized by flattened anterior vertebral bodies. CONCLUSION Long bone shortening is not a sufficient and accurate sign for early sonographic differential diagnosis between TD and OI-2. Angled diaphysis, axial diaphyseal displacement and a conserved vertebral body height in the prenatal period support the diagnosis of osteogenesis imperfecta type 2, while moderately regular bowed diaphysis associated with platyspondyly that of thanatophoric dysplasia.
Collapse
Affiliation(s)
- Maria Pia Bondioni
- Pediatric Radiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, P.le Spedali Civili n. 1, 25100, Brescia, Italy.
| | - Ugo Ernesto Pazzaglia
- Orthopaedic Clinic, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Claudia Izzi
- Prenatal Diagnosis Unit, Department of Obstretics and Gynecology, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Giuseppe Di Gaetano
- Pediatric Radiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, P.le Spedali Civili n. 1, 25100, Brescia, Italy
| | - Francesco Laffranchi
- Pediatric Radiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, P.le Spedali Civili n. 1, 25100, Brescia, Italy
| | - Maurizia Baldi
- Genetic Laboratory Galliera Hospital Genova, Genoa, Italy
| | - Federico Prefumo
- Prenatal Diagnosis Unit, Department of Obstretics and Gynecology, ASST Spedali Civili of Brescia, Brescia, Italy
| |
Collapse
|
21
|
Metatropic dysplasia in third trimester of pregnancy and a novel causative variant in the TRPV4 gene. Eur J Med Genet 2017; 60:365-368. [DOI: 10.1016/j.ejmg.2017.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 04/06/2017] [Accepted: 04/10/2017] [Indexed: 12/22/2022]
|
22
|
Wong HS. A revisit of the fetal foot length and fetal measurements in early pregnancy sonography. Int J Womens Health 2017; 9:199-204. [PMID: 28450790 PMCID: PMC5399981 DOI: 10.2147/ijwh.s122586] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objectives To present the fetal measurements in relation to the foot length at 10–16 weeks gestation on antenatal ultrasound. Materials and methods We reviewed the fetal measurements in 47 scans performed at 10–16 weeks gestation in women attending routine antenatal care. The fetal measurements and measurement ratios were examined in relation to the foot length. Results The fetal biparietal diameter, head circumference, abdominal circumference, femur length and foot length increase linearly with the gestational age at 10–16 weeks gestation. The correlation between fetal foot length and fetal biparietal diameter, head circumference, abdominal circumference and femur length are better than with the crown rump length. The femur length to foot length ratio and the femur length to abdominal circumference ratios increase with the gestational age in an inverse relationship throughout the same period. Conclusion Fetal foot length is an accurate estimate of the gestational age in early pregnancy. Compared with crown rump length, the correlation between foot length and other fetal measurements is better. The fetal measurements ratios are gestational age dependent between 10–16 weeks. Gestational age specific ratio should be used in this period.
Collapse
Affiliation(s)
- Hong Soo Wong
- Australian Women's Ultrasound Centre, Brisbane, Queensland, Australia.,Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong
| |
Collapse
|
23
|
A Case of Thanatophoric Dysplasia Type I with Fetal Hydrops in the First Trimester. Case Rep Obstet Gynecol 2016; 2016:1821230. [PMID: 27006844 PMCID: PMC4781948 DOI: 10.1155/2016/1821230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 01/26/2016] [Accepted: 01/26/2016] [Indexed: 11/24/2022] Open
Abstract
During a routine prenatal exam, a 36-year-old female in her third pregnancy was diagnosed with fetal hydrops at 11 weeks of gestation. The pregnancy was monitored with periodic ultrasounds; however, spontaneous resolution was not observed. Amniotic fluid examination at 16 weeks of gestation showed a normal karyotype; however, macrocephaly, a narrow thorax, and shortening of the long bones were observed on ultrasonography. With the strong suspicion of a fetal skeletal disease, specifically thanatophoric dysplasia (TD), and after extensive genetic counseling, termination of the pregnancy was performed per the parents' wishes with mechanical cervical dilation and gemeprost (PGE1) administration. Following delivery, the fetus was found to have macrocephaly, a narrow bell-shaped thorax, and a protuberant abdomen, as well as curved long bones, H-shaped platyspondyly, and curved clavicles on skeletal radiography. As a result, the fetus was diagnosed with TD type I. This case illustrates that although TD is a rare disease, an accurate prenatal diagnosis can be made with the use of ultrasonography.
Collapse
|
24
|
Liao YM, Li SL, Luo GY, Wen HX, Ouyang SY, Chen CY, Yao Y, Bi JR, Tian XX. Routine screening for fetal limb abnormalities in the first trimester. Prenat Diagn 2015; 36:117-26. [PMID: 26573084 DOI: 10.1002/pd.4724] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 10/27/2015] [Accepted: 11/10/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Yi-Mei Liao
- Department of Ultrasound; Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University; Shenzhen Guangdong China
| | - Sheng-li Li
- Department of Ultrasound; Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University; Shenzhen Guangdong China
| | - Guo-yang Luo
- Department of Obstetrics & Gynecology, School of Medicine; University of Connecticut; Farmington CT USA
| | - Hua-xuan Wen
- Department of Ultrasound; Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University; Shenzhen Guangdong China
| | - Shu-yuan Ouyang
- Department of Central Laboratory, Shenzhen Maternity & Child Healthcare Hospital; Southern Medical University; Shenzhen Guangdong China
| | - Cong-ying Chen
- Department of Ultrasound; Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University; Shenzhen Guangdong China
| | - Yuan Yao
- Department of Ultrasound; Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University; Shenzhen Guangdong China
| | - Jing-ru Bi
- Department of Ultrasound; Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University; Shenzhen Guangdong China
| | - Xiao-xian Tian
- Department of Ultrasound; Maternity & Child Healthcare Hospital of Guangxi Zhuang Autonomous Region; Nanning Guangxi China
| |
Collapse
|
25
|
Westgren M, Götherström C. Stem cell transplantation before birth - a realistic option for treatment of osteogenesis imperfecta? Prenat Diagn 2015; 35:827-32. [PMID: 25962526 DOI: 10.1002/pd.4611] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 04/28/2015] [Accepted: 04/28/2015] [Indexed: 01/17/2023]
Abstract
Osteogenesis imperfecta (OI) is characterized by severe bone deformities, growth retardation and bones that break easily, often from little or no apparent cause. OI is a genetic disorder primarily with defective type I collagen with a wide spectrum of clinical expression. In the more severe cases, it can be diagnosed before birth. Transplantation of mesenchymal stem cells (MSC) has the potential to improve the bone structure and stability, growth and fracture healing. Prenatal and postnatal cell transplantation has been investigated in preclinical and clinical studies of OI and suggests that this procedure is safe and has positive effects. Cell transplantation resulted in improved linear growth, mobility and reduced fracture incidence. However, the effect is transient and for this reason re-transplantation may be needed. So far there is limited experience in this area, and proper studies are required to accurately determine if MSC transplantation is of clinical benefit in the treatment of OI. In this review, we summarize what is currently known in this field.
Collapse
Affiliation(s)
- Magnus Westgren
- Center for Fetal Medicine, Karolinska University Hospital, Stockholm, Sweden.,Division of Obstetrics and Gynaecology, Karolinska Institutet, Stockholm, Sweden
| | - Cecilia Götherström
- Division of Obstetrics and Gynaecology, Karolinska Institutet, Stockholm, Sweden.,Center for Haematology and Regenerative Medicine, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
26
|
Everett TR, Chitty LS. Cell-free fetal DNA: the new tool in fetal medicine. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2015; 45:499-507. [PMID: 25483938 PMCID: PMC5029578 DOI: 10.1002/uog.14746] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 10/31/2014] [Accepted: 11/25/2014] [Indexed: 06/04/2023]
Affiliation(s)
- T R Everett
- Fetal Medicine Unit, University College London Hospital NHS Foundation Trust, London, UK
| | | |
Collapse
|
27
|
Abstract
Ultrasonography is a safe, cost-effective tool used to prenatally detect common musculoskeletal conditions, including clubfoot, skeletal dysplasias, limb-length discrepancies, spinal abnormalities, and hand and other upper extremity deformities. With increased detection of such abnormalities, prenatal parental counseling by orthopaedic surgeons is being requested more frequently. Counseling is important for family education on prognosis and treatment options. A thorough understanding of the common musculoskeletal conditions diagnosed on prenatal ultrasonography, classification of these conditions, and the correlations of these classifications to postnatal severity allows the orthopaedic surgeon to conduct well-informed counseling sessions with families. Accurate information and counseling aids parents in understanding their child's diagnosis, assists clinicians in planning treatment algorithms, and optimizes family preparedness.
Collapse
|
28
|
Zhen L, Pan M, Han J, Yang X, Liao C, Li DZ. Increased first-trimester nuchal translucency associated with thanatophoric dysplasia type 1. J OBSTET GYNAECOL 2015; 35:685-7. [PMID: 25671245 DOI: 10.3109/01443615.2015.1006593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Thanatophoric dysplasia (TD) is the most frequent form of lethal skeletal dysplasia. Prenatal diagnosis is commonly accomplished in the second-trimester scan, but occasionally TD is found to be associated with increased nuchal translucency (NT) at first-trimester screening for aneuploidies. TD may not be clearly distinguished from the other skeletal dysplasias. A definite diagnosis can be established by molecular genetic analysis to find out the abnormal mutations in the fibroblast growth factor receptor 3 (FGFR3) gene. We reported a case of TD type 1 detected by first-trimester NT measurement, and confirmed by molecular analysis of FGFR3 gene using high-resolution melting analysis.
Collapse
Affiliation(s)
- L Zhen
- a Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University , Guangzhou, Guangdong , China
| | - M Pan
- a Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University , Guangzhou, Guangdong , China
| | - J Han
- a Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University , Guangzhou, Guangdong , China
| | - X Yang
- a Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University , Guangzhou, Guangdong , China
| | - C Liao
- a Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University , Guangzhou, Guangdong , China
| | - D Z Li
- a Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University , Guangzhou, Guangdong , China
| |
Collapse
|
29
|
Bildner A. Prenatal Sonographic Detection of Skeletal Dysplasias. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2014. [DOI: 10.1177/8756479314528754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Skeletal dysplasias are a genetically heterogeneous group of disorders that can be diagnosed prenatally by sonography. Differentiating these disorders in the prenatal period can be difficult. However, differentiating known lethal disorders from nonlethal disorders can improve patient care and plan of action. This case study presents multiple pterygia, flexion contractures, and skeletal abnormalities, which are consistent with multiple pterygium syndrome, or Escobar syndrome.
Collapse
|
30
|
Abstract
In this review, we discuss aspects of the prenatal diagnosis of fetal skeletal malformations, concentrating on the advantages offered by different imaging techniques and the approaches that are of value in evaluating a suspected skeletal dysplasia. We also briefly address the findings in some of the commoner malformations of the fetal skeleton that may be encountered.
Collapse
Affiliation(s)
- Ann-Edwidge Noel
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, McGill University, Montreal, QC, Canada
| | - Richard N Brown
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, McGill University, Montreal, QC, Canada
| |
Collapse
|
31
|
Chitty LS. Cell-free DNA testing: An aid to prenatal sonographic diagnosis. Best Pract Res Clin Obstet Gynaecol 2014; 28:453-66. [DOI: 10.1016/j.bpobgyn.2014.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Accepted: 01/08/2014] [Indexed: 11/29/2022]
|
32
|
Abstract
Prenatal magnetic resonance imaging (MRI) is being increasingly used, in addition to standard ultrasound, for the diagnosis of congenital diseases beyond the central nervous system. Previous studies have demonstrated that MRI may be useful for the in utero visualization of spinal dysraphism and for differentiating between isolated and complex skeletal disorders with associated abnormalities. More recently, attention has focused on the visualization of the human fetal skeleton for the delineation of normal and pathological development of skeletal structures. On 1.5 T, in particular, echoplanar imaging enables the delineation of various epimetaphyseal structures and morphometric measurements of the fetal long bones from 18 gestational weeks until term. This information gathered from prenatal MRI might be helpful in the diagnosis of focal bone abnormalities and generalized skeletal disorders, such as bone dysplasias. Further clinical research, along with the refinement of the newest techniques, will enable expansion of the preliminary findings and help in determining the impact of fetal magnetic resonance bone imaging in the routine clinical setting. This review summarizes the current data in the literature and the authors' clinical experience with the magnetic resonance visualization of the developing fetal skeleton and also comments on the potential future applications of this technique.
Collapse
|
33
|
Iliescu D, Tudorache S, Comanescu A, Antsaklis P, Cotarcea S, Novac L, Cernea N, Antsaklis A. Improved detection rate of structural abnormalities in the first trimester using an extended examination protocol. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2013; 42:300-9. [PMID: 23595897 DOI: 10.1002/uog.12489] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Revised: 10/02/2012] [Accepted: 11/28/2012] [Indexed: 05/21/2023]
Abstract
OBJECTIVE To assess the potential of first-trimester sonography in the detection of fetal abnormalities using an extended protocol that is achievable with reasonable resources of time, personnel and ultrasound equipment. METHODS This was a prospective two-center 2-year study of 5472 consecutive unselected pregnant women examined at 12 to 13 + 6 gestational weeks. Women were examined using an extended morphogenetic ultrasound protocol that, in addition to the basic evaluation, involved a color Doppler cardiac sweep and identification of early contingent markers for major abnormalities. RESULTS The prevalence of lethal and severe malformations was 1.39%. The first-trimester scan identified 40.6% of the cases detected overall and 76.3% of major structural defects. The first-trimester detection rate (DR) for major congenital heart disease (either isolated or associated with extracardiac abnormalities) was 90% and that for major central nervous system anomalies was 69.5%. In fetuses with increased nuchal translucency (NT), the first-trimester DR for major anomalies was 96%, and in fetuses with normal NT it was 66.7%. Most (67.1%) cases with major abnormalities presented with normal NT. CONCLUSIONS A detailed first-trimester anomaly scan using an extended protocol is an efficient screening method to detect major fetal structural abnormalities in low-risk pregnancies. It is feasible at 12 to 13 + 6 weeks with ultrasound equipment and personnel already used for routine first-trimester screening. Rate of detection of severe malformations is greater in early- than in mid-pregnancy and on postnatal evaluation. Early heart investigation could be improved by an extended protocol involving use of color Doppler.
Collapse
Affiliation(s)
- D Iliescu
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Craiova, Romania.
| | | | | | | | | | | | | | | |
Collapse
|
34
|
Lewis C, Hill M, Chitty L. Non-invasive prenatal diagnosis for single gene disorders: experience of patients. Clin Genet 2013; 85:336-42. [DOI: 10.1111/cge.12179] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 04/26/2013] [Accepted: 04/26/2013] [Indexed: 12/01/2022]
Affiliation(s)
| | - M. Hill
- Clinical and Molecular Genetics; Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust; London UK
| | - L.S. Chitty
- Clinical and Molecular Genetics; Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust; London UK
- Fetal Medicine Unit; University College London Hospitals NHS Foundation Trust; London UK
| |
Collapse
|
35
|
Breeze ACG, Lees CC. Antenatal diagnosis and management of life-limiting conditions. Semin Fetal Neonatal Med 2013; 18:68-75. [PMID: 23063800 DOI: 10.1016/j.siny.2012.09.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Whereas structural fetal abnormalities are relatively frequent occurrences, many of these do not impact measurably on future life and/or are amenable to postnatal therapy. A small minority are considered to be potentially lethal or life-limiting. Examples include specific skeletal dysplasias, urinary tract abnormalities - typically those which lead to anhydramnios and pulmonary hypoplasia, some disorders of the central nervous system and trisomies 13 and 18. Without seeking to compile an exhaustive list of such conditions, we discuss the principles and new considerations in relation to antenatal diagnosis and perinatal management of such disorders.
Collapse
Affiliation(s)
- Andrew C G Breeze
- Kingston Hospital NHS Trust, Galsworthy Road, Kingston-upon-Thames KT2 7QB, UK
| | | |
Collapse
|
36
|
Chitty LS, Khalil A, Barrett AN, Pajkrt E, Griffin DR, Cole TJ. Safe, accurate, prenatal diagnosis of thanatophoric dysplasia using ultrasound and free fetal DNA. Prenat Diagn 2013; 33:416-23. [PMID: 23408600 PMCID: PMC4166694 DOI: 10.1002/pd.4066] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objective To improve the prenatal diagnosis of thanatophoric dysplasia by defining the change in fetal size across gestation and the frequency of sonographic features, and developing non-invasive molecular genetic diagnosis based on cell-free fetal DNA (cffDNA) in maternal plasma. Methods Fetuses with a confirmed diagnosis of thanatophoric dysplasia were ascertained, records reviewed, sonographic features and measurements determined. Charts of fetal size were then constructed using the LMS (lambda-mu-sigma) method and compared with charts used in normal pregnancies and those complicated by achondroplasia. Cases in this cohort referred to our Regional Genetics Laboratory for molecular diagnosis using cffDNA were identified and results reviewed. Results Forty-two cases were scanned in our units. Commonly reported sonographic features were very short and sometimes bowed femora, frontal bossing, cloverleaf skull, short fingers, a small chest and polyhydramnios. Limb shortening was obvious from as early as 13 weeks' gestation, with minimal growth after 20 weeks. Analysis of cffDNA in three of these pregnancies confirmed the presence of the c.742C>CT (p.Arg248Cys) or the c.1948A>AG (p.Lys650Glu) mutation in the fibroblast growth factor receptor 3 gene. Conclusion These data should improve the accuracy of the sonographic diagnosis of thanatophoric dysplasia and have implications for reliable and safe targeted molecular confirmation using cffDNA. © 2013 The Authors. Prenatal Diagnosis published by John Wiley & Sons Ltd.
Collapse
Affiliation(s)
- Lyn S Chitty
- Clinical and Molecular Genetics Unit, UCL Institute of Child Health, University College London, UK.
| | | | | | | | | | | |
Collapse
|
37
|
Donnelly JC, Malone FD. Early fetal anatomical sonography. Best Pract Res Clin Obstet Gynaecol 2012; 26:561-73. [PMID: 22776410 DOI: 10.1016/j.bpobgyn.2012.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Accepted: 06/13/2012] [Indexed: 11/25/2022]
Abstract
Over the past decade, prenatal screening and diagnosis has moved from the second into the first trimester, with aneuploidy screening becoming both feasible and effective. With vast improvements in ultrasound technology, sonologists can now image the fetus in greater detail at all gestational ages. In the hands of experienced sonographers, anatomic surveys between 11 and 14 weeks can be carried out with good visualisation rates of many structures. It is important to be familiar with the normal development of the embryo and fetus, and to be aware of the major anatomical landmarks whose absence or presence may be deemed normal or abnormal depending on the gestational age. Some structural abnormalities will nearly always be detected, some will never be and some are potentially detectable depending on a number of factors.
Collapse
Affiliation(s)
- Jennifer C Donnelly
- Royal College of Surgeons in Ireland, Rotunda Hospital, Parnell Square, Dublin, Ireland.
| | | |
Collapse
|
38
|
Nemec U, Nemec SF, Kasprian G, Brugger PC, Bettelheim D, Wadhawan I, Kolb A, Graham JM, Rimoin DL, Prayer D. Clubfeet and associated abnormalities on fetal magnetic resonance imaging. Prenat Diagn 2012; 32:822-8. [PMID: 22678996 DOI: 10.1002/pd.3911] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Clubfoot, or talipes equinovarus (TEV), is commonly diagnosed on prenatal ultrasound. This study sought to visualize TEV and associated abnormalities on fetal magnetic resonance imaging (MRI) compared with ultrasound. METHODS This retrospective study included the MRI scans of 44 fetuses with TEV using postnatal assessment and autopsy as standard of reference. Isolated TEV was differentiated from complex TEV with associated abnormalities. MRI findings and previous ultrasound diagnoses were compared. RESULTS Isolated TEV was found in 19/44 (43.2%) fetuses and complex TEV in 25/44 (56.8%). Associated abnormalities consisted of the following: central nervous system/spinal abnormalities in 13/25 (52.0%) fetuses; musculoskeletal abnormalities in 7/25 (28.0%); thoracic abnormalities in 3/25 (12.0%); a tumor in one case; and hydrops fetalis in one. Of the 44 cases, 35 (79.5%) pregnancies were delivered, and nine (20.5%) pregnancies, which were terminated, all had complex TEV. Of the 42 available ultrasound reports, additional MRI findings were made in 8/42 (19.0%) cases. MRI did not add findings in isolated TEV on ultrasound. In 4/44 (9.1%) cases, autopsy revealed additional findings compared with prenatal imaging. CONCLUSION Fetal MRI enables differentiation between isolated and complex TEV. Isolated TEV on ultrasound may not be an MRI indication, whereas MRI may be useful in cases of complex TEV.
Collapse
Affiliation(s)
- Ursula Nemec
- Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University Vienna, Vienna, Austria.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Nemec SF, Nemec U, Brugger PC, Bettelheim D, Rotmensch S, Graham JM, Rimoin DL, Prayer D. MR imaging of the fetal musculoskeletal system. Prenat Diagn 2012; 32:205-13. [DOI: 10.1002/pd.2914] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Stefan Franz Nemec
- Medical University Vienna; Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology; Waehringer Guertel 18-20 Vienna A-1090 Austria
- Cedars Sinai Medical Center; Medical Genetics Institute, 8700 Beverly Boulevard, PACT Suite 400; 8700 Beverly Boulevard, PACT Suite 400 Los Angeles CA, 90048 90048 USA
| | - Ursula Nemec
- Medical University Vienna; Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology; Waehringer Guertel 18-20 Vienna A-1090 Austria
| | - Peter C. Brugger
- Medical University Vienna; Center of Anatomy and Cell Biology, Integrative Morphology Group; Vienna Austria
| | - Dieter Bettelheim
- Medical University Vienna; Department of Obstetrics and Gynaecology, Division of Prenatal Diagnosis and Therapy; Vienna Austria
| | - Siegfried Rotmensch
- Cedars Sinai Medical Center; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine; Los Angeles CA USA
| | - John M. Graham
- Cedars Sinai Medical Center; Medical Genetics Institute, 8700 Beverly Boulevard, PACT Suite 400; 8700 Beverly Boulevard, PACT Suite 400 Los Angeles CA, 90048 90048 USA
| | - David L. Rimoin
- Cedars Sinai Medical Center; Medical Genetics Institute, 8700 Beverly Boulevard, PACT Suite 400; 8700 Beverly Boulevard, PACT Suite 400 Los Angeles CA, 90048 90048 USA
| | - Daniela Prayer
- Medical University Vienna; Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology; Waehringer Guertel 18-20 Vienna A-1090 Austria
| |
Collapse
|
40
|
|
41
|
|
42
|
Nicolaides KH. A model for a new pyramid of prenatal care based on the 11 to 13 weeks' assessment. Prenat Diagn 2011; 31:3-6. [PMID: 21210474 DOI: 10.1002/pd.2685] [Citation(s) in RCA: 163] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|