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Arumugam S, Kalluri SS, Sharmila V, Subbiah NK, Mocherla A, Kulkarni J, Ghoshal JA. Acceptability of Prenatal Screening Tests Among Expectant Mothers in India: Insights and Implications for Public Health. Cureus 2024; 16:e61246. [PMID: 38939276 PMCID: PMC11210580 DOI: 10.7759/cureus.61246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2024] [Indexed: 06/29/2024] Open
Abstract
INTRODUCTION Prenatal screening tests are essential for preventing common genetic disorders, yet their acceptability among pregnant women in India remains unexplored. This study aims to investigate the acceptability of prenatal screening tests and their correlation with demographic characteristics among pregnant women in India. METHODS A cross-sectional study was conducted at a tertiary care, public hospital, involving 200 pregnant women. Data were collected through a self-administered questionnaire assessing demographic information and the acceptability of prenatal screening tests. Statistical analysis included chi-square tests and logistic regression. RESULTS Most participants demonstrated adequate acceptability toward prenatal screening tests, with 73% scoring above the threshold. Factors associated with higher acceptability included younger maternal age, second-trimester gestational age, higher education, salaried employment, and urban residence. However, factors such as parity, consanguinity, mode of conception, and family history of genetic disease showed no significant associations. CONCLUSION The study highlights positive attitudes toward prenatal screening tests among pregnant women in India, particularly among younger, more educated, and urban populations. These findings emphasize the need for targeted interventions to enhance awareness and accessibility of prenatal screening, ultimately contributing to the reduction of the genetic disorder burden in India.
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Affiliation(s)
- Sangeetha Arumugam
- Anatomy, All India Institute of Medical Sciences, Mangalagiri, Mangalagiri, IND
| | - Sri Sowmya Kalluri
- Obstetrics and Gynecology, Siddhartha Medical College, Vijayawada, IND
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Mangalagiri, Mangalagiri, IND
| | - Vijayan Sharmila
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Mangalagiri, Mangalagiri, IND
| | | | - Akarsh Mocherla
- Anatomy, All India Institute of Medical Sciences, Mangalagiri, Mangalagiri, IND
| | - Jyoti Kulkarni
- Anatomy, All India Institute of Medical Sciences, Mangalagiri, Mangalagiri, IND
| | - Joy A Ghoshal
- Anatomy, All India Institute of Medical Sciences, Mangalagiri, Mangalagiri, IND
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Ju J, Su F, Chen C, Sun J, Gao Y. Haplotype-Assisted Noninvasive Prenatal Diagnosis of Genetic Diseases by Massively Parallel Sequencing of Maternal Plasma Cell-Free DNA. Methods Mol Biol 2023; 2590:287-294. [PMID: 36335505 DOI: 10.1007/978-1-0716-2819-5_17] [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] [Indexed: 06/16/2023]
Abstract
Early prenatal diagnosis of genetic diseases allows for timely intervention or prevention of the diseases in newborns. Conventional prenatal diagnosis of most genetic diseases relies on testing fetal DNA obtained by invasive procedures such as amniocentesis or chorionic villus sampling, which are associated with small risks of fetal loss. Maternal circulating blood contains cell-free DNA (cfDNA) from the fetal genome and can thus be used to noninvasively detect fetal genetic diseases such as chromosomal abnormalities, copy number variants, and single gene diseases. However, due to the presence of a high level of maternal cfDNA in the maternal blood stream, a relative haplotype dosage (RHDO) analysis is required to detect the mutant loci in the fetal genome when performing noninvasive prenatal diagnosis (NIPD) by massively parallel sequencing (MPS) of cfDNA. In this chapter, we describe a protocol utilizing the RHDO strategy for NIPD of any gene of interest associating with single gene diseases.
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Affiliation(s)
- Jia Ju
- BGI-Shenzhen, Shenzhen, China
| | | | - Chao Chen
- BGI Genomics, BGI-Shenzhen, Shenzhen, China
- Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, Tianjin, China
| | - Jun Sun
- BGI Genomics, BGI-Shenzhen, Shenzhen, China
- Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, Tianjin, China
| | - Ya Gao
- BGI-Shenzhen, Shenzhen, China.
- Shenzhen Engineering Laboratory for Birth Defects Screening, Shenzhen, China.
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Yang H, Yang S, Shen H, Wu S, Ruan J, Lyu G. Construction of the amniotic fluid-derived exosomal ceRNA network associated with ventricular septal defect. Genomics 2021; 113:4293-4302. [PMID: 34758360 DOI: 10.1016/j.ygeno.2021.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 10/28/2021] [Accepted: 11/03/2021] [Indexed: 01/08/2023]
Abstract
Ventricular septal defect (VSD) is the most frequent congenital cardiac malformations. Amniotic fluid (AF) contains a higher abundance of biological compounds that could reflect fetal health information. The aims of our study were to construct a competitive endogenous RNA (ceRNA) network based on AF-derived exosomal ncRNAs. We conducted whole transcriptome profiling in six pairs of AF-derived exosomes from VSD fetuses and matched healthy controls. A total of 1252 differentially expressed (DE) mRNAs, 256 DE-miRNAs and 1090 DE-lncRNAs were found to be significantly altered in the VSD group. We constructed a ceRNA regulatory network including 46 mRNAs, 11 miRNAs and 47 lncRNAs. The expression level of 6 hub RNAs were validated using qRT-PCR. In conclusion, AF-derived exosomal VSD-related ceRNAs provide a basis for a better understanding of the role of ncRNAs in the pathogenesis and mechanisms of VSD, which may lead to the discovery of potential diagnostic biomarkers for fetal VSD.
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Affiliation(s)
- Hainan Yang
- Department of Ultrasound, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
| | - Shuping Yang
- Department of Ultrasound, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China
| | - Haolin Shen
- Department of Ultrasound, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China
| | - Shufen Wu
- Department of Ultrasound, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China
| | - Junxian Ruan
- Department of Ultrasound, Quanzhou Women's and Children's Hospital, Quanzhou, Fujian, China
| | - Guorong Lyu
- Department of Ultrasound, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China; Collaborative Innovation Center for Maternal and Infant Health Service Application Technology of Education Ministry, Quanzhou Medical College, Quanzhou, Fujian, China.
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Benefit versus risk of chromosomal microarray analysis performed in pregnancies with normal and positive prenatal screening results: A retrospective study. PLoS One 2021; 16:e0250734. [PMID: 33901244 PMCID: PMC8075189 DOI: 10.1371/journal.pone.0250734] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 04/12/2021] [Indexed: 11/19/2022] Open
Abstract
Background Most studies on chromosomal microarray analysis (CMA) and amniocentesis risks have not evaluated pregnancies with low risk for genetic diseases; therefore, the efficacy and safety of CMA and amniocentesis in this population are unclear. This study aimed to examine the benefits and risks of prenatal genetic diagnostic tests in pregnancies having low risk for chromosomal diseases. Methods and findings In this retrospective study, we used clinical data from a large database of 30,830 singleton pregnancies at gestational age 16–23 weeks who underwent amniocentesis for karyotyping with or without CMA. We collected socio-demographic, medical and obstetric information, along with prenatal screening, CMA and karyotyping results. Fetal loss events were also analysed. CMA was performed in 5,837 pregnancies with normal karyotype (CMA cohort). In this cohort, 4,174 women had normal prenatal screening results and the risk for identifying genetic abnormalities with >10% risk for intellectual disability by CMA was 1:102, with no significant difference between maternal age groups. The overall post-amniocentesis fetal loss rate was 1:1,401 for the entire cohort (n = 30,830) and 1:1,945 for the CMA cohort (n = 5,837). The main limitation of this study is the relatively short follow-up of 3 weeks, which may not have been sufficient for detecting all fetal loss events. Conclusion The low risk for post-amniocentesis fetal loss, compared to the rate of severe genetic abnormalities detected by CMA, suggests that even pregnant women with normal prenatal screening results should consider amniocentesis with CMA.
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Svirsky R, Pekar-Zlotin M, Rozovski U, Maymon R. Indications for genetic testing leading to termination of pregnancy. Arch Gynecol Obstet 2019; 300:1221-1225. [PMID: 31529364 DOI: 10.1007/s00404-019-05289-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 09/03/2019] [Indexed: 01/08/2023]
Abstract
PURPOSE In this study, we aimed to assess the distribution of genetic abnormalities leading to termination of pregnancy and its fluctuation during the past 8 years in light of those technical advances. METHODS Our cohort consisted of all pregnant women who underwent termination of pregnancy because of genetic aberrations in their fetuses from January 2010 through April 2018 in our medical center. The information that was gathered included: maternal age, results of the nuchal scan, results of the first- and second-trimester biochemical screening, ultrasonographic findings, reasons for conducting a genetic evaluation, gestational age at which termination of pregnancy was carried out, and the type of genetic aberration. RESULTS 816 women underwent termination of pregnancy at our institution due to genetic aberrations, most of them because of positive biochemical screening (n = 297, 36%) or because of maternal anxiety (n = 283, 35%). Findings in chromosomal microarray led to termination of pregnancy in 100 women (100/816, 12%). Chromosomal microarray had been performed due to maternal choice and not because of accepted medical indications among most of the women who underwent termination of pregnancy due to findings on chromosomal microarray (69/100, 69%). CONCLUSION Performing chromosomal microarray on a structurally normal fetus and identifying abnormal copy number variants may give the parents enough information for deciding on the further course of the pregnancy.
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Affiliation(s)
- Ran Svirsky
- Department of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center (Formerly Assaf Harofeh Medical Center) (affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel), Zerifin, Israel.
| | - Marina Pekar-Zlotin
- Department of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center (Formerly Assaf Harofeh Medical Center) (affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel), Zerifin, Israel
| | - Uri Rozovski
- Institute of Hematology, Davidoff Cancer Center, Beilinson Hospital (all affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel), Petach Tikva, Israel
| | - Ron Maymon
- Department of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center (Formerly Assaf Harofeh Medical Center) (affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel), Zerifin, Israel
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Ebert B, Rai AJ. Isolation and Characterization of Amniotic Fluid-Derived Extracellular Vesicles for Biomarker Discovery. Methods Mol Biol 2019; 1885:287-294. [PMID: 30506205 DOI: 10.1007/978-1-4939-8889-1_19] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Amniotic fluid, the fetal-protective liquid that fills the amniotic sac, represents a rich source of biomarkers. The diagnostic utility of amniotic fluid relies on the highly abundant maternal and fetal nucleic acid and proteomic content, which allows for the simultaneous determination of mother and fetal health status. Extracellular vesicles (ECVs) that are released by all cells and found in amniotic fluid could be harnessed to provide substantial clinically actionable data. ECVs are mediators of critical biological functions and reflect the health of the parent cell. Thus, ECVs released from cells in distress may provide important diagnostic information. Here, we describe a straightforward and optimized method for isolating ECVs from amniotic fluid. In addition, we validate our procedure through western blotting using antibodies targeting canonical ECV protein markers and via direct visualization using transmission electron microscopy.
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Affiliation(s)
- Blake Ebert
- Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
| | - Alex J Rai
- Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA.
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Brabbing-Goldstein D, Reches A, Svirsky R, Bar-Shira A, Yaron Y. Dilemmas in genetic counseling for low-penetrance neuro-susceptibility loci detected on prenatal chromosomal microarray analysis. Am J Obstet Gynecol 2018; 218:247.e1-247.e12. [PMID: 29146387 DOI: 10.1016/j.ajog.2017.11.559] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 10/14/2017] [Accepted: 11/06/2017] [Indexed: 01/03/2023]
Abstract
BACKGROUND Chromosomal microarray analysis is standard of care in fetuses with malformations, detecting clinically significant copy number variants in 5-7% of cases over conventional karyotyping. However, it also detects variants of uncertain significance in 1.6-4.2% of the cases, some of which are low-penetrance neuro-susceptibility loci. The interpretation of these variants in pregnancy is particularly challenging because the significance is often unclear and the clinical implications may be difficult to predict. OBJECTIVE The purpose of this study was to describe counseling dilemmas regarding low-penetrance neuro-susceptibility loci that are detected by prenatal chromosomal microarray analysis. STUDY DESIGN During the study period (January 2014 to December 2015), 700 prenatal chromosomal microarray analyses were performed. Cases were categorized as "indicated" (n=375) if there were abnormal sonographic findings or suggestive medical history and "patient choice" (n=325) in the presence of a structurally normal fetus with no other particular indication. The laboratory reported on copy number variants ≥400 Kb in size in loci known to be associated with genetic syndromes and ≥1 Mb in other areas of genome. Results were classified as gross aneuploidy, copy number variants, and normal. Copy number variants were categorized according to the American College of Medical Genetics standards and guidelines: pathogenic, variants of uncertain significance, or benign. Variants of uncertain significance were further subdivided into categories of likely pathogenic, variants of uncertain significance with no subclassification, and likely benign. Statistical analysis was performed with the use of Chi square test and Fisher's exact test to compare intergroup differences in incidence of the different result categories and demographic data. RESULTS Patient choice cases became more prevalent with time (35.5% in the beginning of the study, compared with 48.4% at the end of the study period). Clinically significant copy number variants were found in 14 of 375 (3.7%) of indicated cases vs only 2 of 325 (0.6%) of patient choice cases (P=.009). All "likely benign" variants consisted of low-penetrance neuro-susceptibility loci. The incidence thereof was similar between the indicated and patient choice groups (3.7% vs 3.4%; P=.85). In the indicated group, some variants of uncertain significance may have contributed to the abnormal anatomic findings. Conversely, in the patient choice group, the finding of low-penetrance neuro-susceptibility loci was often unexpected and confounding for prospective parents. CONCLUSION Prenatal chromosomal microarray analysis added clinically significant information in both groups. However, it also detected low-penetrance neuro-susceptibility loci in approximately 3.5% of the cases. This fact should be conveyed during pretest counseling to allow patients to make informed choices, particularly when chromosomal microarray is to be performed for patient choice.
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Maya I, Yacobson S, Kahana S, Yeshaya J, Tenne T, Agmon-Fishman I, Cohen-Vig L, Shohat M, Basel-Vanagaite L, Sharony R. Cut-off value of nuchal translucency as indication for chromosomal microarray analysis. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2017; 50:332-335. [PMID: 28133835 DOI: 10.1002/uog.17421] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 01/03/2017] [Accepted: 01/18/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVES An association between isolated, increased nuchal translucency thickness (NT) and pathogenic findings on chromosomal microarray analysis (CMA) has been reported. A recent meta-analysis reported that most studies use a NT cut-off value of 3.5 mm. However, considering NT distribution and the commonly accepted 5% false-positive rate in maternal serum screening, NT cut-off levels should be reconsidered. The aim of this study was to assess different NT cut-off levels as indication for CMA and to determine whether CMA should be recommended for mildly increased NT of 3.0-3.4 mm. METHODS This was a retrospective, multicenter study of singleton pregnancies with CMA results and either normal NT and no other finding or with increased NT as the only medical indication for CMA at the time of an invasive procedure (increased NT was considered an isolated finding in cases of advanced maternal age). Women with normal fetal NT who underwent CMA did so at their own request. A single laboratory performed all genetic analyses. Comparative genomic hybridization microarray analysis or single nucleotide polymorphism array technology was used for CMA. If combined first-trimester screening (NT and biochemistry) indicated increased risk for common aneuploidies, the case was excluded. NT was used to divide cases into three groups (≤ 2.9 mm, 3.0-3.4 mm and ≥ 3.5 mm) and their CMA results were compared. RESULTS CMA results were recorded in 1588 pregnancies, among which 770 fetuses had either normal NT with no other finding or isolated increased NT. Of these, 462 had NT ≤ 2.9 mm, 170 had NT of 3.0-3.4 mm and 138 had NT ≥ 3.5 mm. Pathogenic copy number variants were found in 1.7%, 6.5% and 13.8% of cases, respectively. CONCLUSION Our results suggest that CMA should be recommended when fetuses have isolated, mildly increased NT (3.0-3.4 mm). Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- I Maya
- Recanati Genetics Institute, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel
| | - S Yacobson
- Recanati Genetics Institute, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel
| | - S Kahana
- Recanati Genetics Institute, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel
| | - J Yeshaya
- Recanati Genetics Institute, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel
| | - T Tenne
- The Genetics Institute, Meir Medical Center, Kfar Saba, Israel
| | - I Agmon-Fishman
- Recanati Genetics Institute, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel
| | - L Cohen-Vig
- Recanati Genetics Institute, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel
| | - M Shohat
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Bioinformatics Unit, Sheba Cancer Research Center, Sheba Medical Center, Tel Hashomer, Israel
| | - L Basel-Vanagaite
- Recanati Genetics Institute, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Genetics Unit, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
- Felsenstein Medical Research Center, Rabin Medical Center, Petah Tikva, Israel
| | - R Sharony
- The Genetics Institute, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel
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Seven M, Eroglu K, Akyüz A, Ingvoldstad C. Educational needs of nurses to provide genetic services in prenatal care: A cross-sectional study from Turkey. Nurs Health Sci 2017; 19:294-300. [DOI: 10.1111/nhs.12344] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 01/26/2017] [Accepted: 01/28/2017] [Indexed: 12/17/2022]
Affiliation(s)
- Memnun Seven
- Koç University; School of Nursing; İstanbul Turkey
| | | | - Aygül Akyüz
- Koç University; School of Nursing; İstanbul Turkey
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Hatirnaz S, Ozer A, Hatirnaz E, Atasever M, Başaranoglu S, Kanat-Pektas M, Api M. Pre-implantation genetic screening among women experiencing recurrent failure of in vitro fertilization. Int J Gynaecol Obstet 2017; 137:314-318. [PMID: 28258586 DOI: 10.1002/ijgo.12135] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 01/12/2017] [Accepted: 02/27/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the efficiency of pre-implantation genetic screening (PGS) among women scheduled to undergo intracytoplasmic sperm injection who had experienced recurrent in vitro fertilization (IVF) failure. METHODS The present retrospective cohort study reviewed the medical records of consecutive women who had experienced recurrent IVF failure and had presented at a private IVF facility in Trabzon Province, Turkey, to undergo intracytoplasmic sperm injection between May 1, 2012, and December 31, 2014. Patient data and perinatal outcomes were compared between patients who underwent PGS and those who did not. RESULTS There were 88 patients included in the study; 43 patients had undergone PGS and 45 had declined to do so. No differences were detected in the clinical pregnancy rate (P=0.846), spontaneous abortion rate (P=0.416), number of perinatal deaths (P=0.162), or the number of live deliveries (P=0.188) between the groups of patients. The pregnancies included in the study resulted in 25 neonates being delivered; 24 had normal karyotypes, and one neonate from the control group had a karyotype of 46, XX, 9ph. Among the 19 embryos that were not transferred, the most frequently encountered chromosomal anomalies were diploidy, monosomy X, and 2N/N/4N mosaicism, detected in 7 (37%), 2 (11%), and 2 (11%) embryos, respectively. CONCLUSION PGS had no effect on perinatal outcomes among women experiencing recurrent IVF failure.
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Affiliation(s)
| | - Alev Ozer
- Department of Obstetrics and Gynecology, Kahramanmaras Sutcu Imam University Hospital, Kahramanmaras, Turkey
| | - Ebru Hatirnaz
- Private Bilge Hospital, Kucukkoy, Gaziosmanpasa, Turkey
| | - Melahat Atasever
- Department of Obstetrics and Gynecology, Giresun University Hospital, Giresun, Turkey
| | | | - Mine Kanat-Pektas
- Department of Obstetrics and Gynecology, Kocatepe University Hospital, Afyon, Turkey
| | - Murat Api
- Department of Obstetrics and Gynecology, Aydin University Hospital, Istanbul, Turkey
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Seven M, Akyüz A, Eroglu K, Daack-Hirsch S, Skirton H. Women's knowledge and use of prenatal screening tests. J Clin Nurs 2017; 26:1869-1877. [PMID: 27487389 DOI: 10.1111/jocn.13494] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2016] [Indexed: 01/16/2023]
Abstract
AIMS AND OBJECTIVES The aim of the study was to determine the rate of use of prenatal screening tests and the factors affecting the decision to have a prenatal screening test in pregnant women in Turkey. BACKGROUND Prenatal genetic screening as an optional service is commonly used to determine a level of risk for genetic conditions in the foetus. DESIGN A quantitative cross-sectional survey. METHODS Pregnant women (n = 274) who sought prenatal care from one hospital in Turkey were recruited and asked to complete questionnaires that were developed by the researchers. Descriptive and inferential statistics were used to analyse the data. RESULTS Almost half (44·2) % of the women were primiparas, and the majority (97·8%) were in the third trimester of pregnancy. Only 36·1% of the women reported that they had prenatal screening by either the double test or triple test. Women had a low level of knowledge regarding prenatal screening: the mean knowledge score was 3·43 ± 3·21 of a possible score of 10. Having consanguineous marriage, a history of spontaneous abortion, a child with genetic disorder, multiparity or a longer marriage duration were positively correlated with accepting a prenatal screening test. CONCLUSIONS This study has provided baseline data on the uptake and reasons for accepting or declining a prenatal screening in a cohort of Turkish women. There is evidence to suggest that more education is needed to improve knowledge and provide comprehensive nursing care to promote informed consent in this context. RELEVANCE TO CLINICAL PRACTICE Perinatal nurses are ideally situated to inform pregnant women about prenatal screening tests to improve access to healthcare services and to ensure informed decisions are made by pregnant women and their partners.
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Affiliation(s)
- Memnun Seven
- School of Nursing, Koç University, İstanbul, Turkey
| | - Aygül Akyüz
- School of Nursing, Koç University, İstanbul, Turkey
| | | | | | - Heather Skirton
- Professor of Applied Health Genetics, Plymouth University, Plymouth, UK
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Kane SC, Reidy KL, Norris F, Nisbet DL, Kornman LH, Palma-Dias R. Chorionic villus sampling in the cell-free DNA aneuploidy screening era: careful selection criteria can maximise the clinical utility of screening and invasive testing. Prenat Diagn 2017; 37:399-408. [DOI: 10.1002/pd.5026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 01/19/2017] [Accepted: 02/12/2017] [Indexed: 01/12/2023]
Affiliation(s)
- Stefan C. Kane
- Pregnancy Research Centre; Department of Maternal Fetal Medicine, The Royal Women's Hospital; Parkville VIC Australia
- The University of Melbourne; Department of Obstetrics and Gynaecology, The Royal Women's Hospital; Parkville VIC Australia
- Ultrasound Department; Pauline Gandel Women's Imaging Centre, The Royal Women's Hospital; Parkville VIC Australia
| | - Karen L. Reidy
- Pregnancy Research Centre; Department of Maternal Fetal Medicine, The Royal Women's Hospital; Parkville VIC Australia
- Ultrasound Department; Pauline Gandel Women's Imaging Centre, The Royal Women's Hospital; Parkville VIC Australia
| | - Fiona Norris
- Victorian Clinical Genetics Services; Parkville VIC Australia
| | - Deborah L. Nisbet
- Ultrasound Department; Pauline Gandel Women's Imaging Centre, The Royal Women's Hospital; Parkville VIC Australia
- Women's Ultrasound Melbourne; Parkville VIC Australia
- The University of Melbourne; Departments of Medicine and Radiology; Parkville VIC Australia
| | - Louise H. Kornman
- The University of Melbourne; Department of Obstetrics and Gynaecology, The Royal Women's Hospital; Parkville VIC Australia
- Ultrasound Department; Pauline Gandel Women's Imaging Centre, The Royal Women's Hospital; Parkville VIC Australia
- Women's Ultrasound Melbourne; Parkville VIC Australia
| | - Ricardo Palma-Dias
- Pregnancy Research Centre; Department of Maternal Fetal Medicine, The Royal Women's Hospital; Parkville VIC Australia
- The University of Melbourne; Department of Obstetrics and Gynaecology, The Royal Women's Hospital; Parkville VIC Australia
- Ultrasound Department; Pauline Gandel Women's Imaging Centre, The Royal Women's Hospital; Parkville VIC Australia
- Women's Ultrasound Melbourne; Parkville VIC Australia
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Chang HP, Chiou JY, Chen JY, Su PH. Prenatal cytogenetic diagnosis in Taiwan: a nationwide population-based study. J Matern Fetal Neonatal Med 2016; 30:2521-2528. [PMID: 27806654 DOI: 10.1080/14767058.2016.1255191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE The goal of this study was to gain a better understanding of the status of advanced maternal age among criteria for provision of amniocentesis in pregnant women in Taiwan. MATERIALS AND METHOD Data of 315 670 second-trimester amniocenteses from 28 national certified cytogenetics laboratories were retrospectively analyzed from the Prenatal Genetic Diagnosis Declaring and Database System of the Health Promotion Administration, Ministry of Health and Welfare in Taiwan between 2006 and 2013. RESULTS The number of pregnant women undergoing amniocentesis in Taiwan between 2006 and 2013 increased, and the most common three indications for amniocentesis were advance maternal age (75.11%), abnormal second trimester maternal serum screening (13.22%) and abnormal sonographic finding (8.00%). Down syndrome was the most common autosomal abnormality identified (25.74%); Turner syndrome was the most common sex chromosome abnormality (7.04%). Of structural rearrangements, 26.93% were balanced translocations and 17.10% were unbalanced translocations. The greatest proportion of fetal chromosomal abnormalities was found in cases where parents were also affected (38.02%). CONCLUSIONS Clinical workers should provide detailed genetic diagnostic information to pregnant women, especially those with the common amniocentesis indications, which will enable them to determine a birth plan.
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Affiliation(s)
- Hua-Pin Chang
- a Institute of Medicine, Chung Shan Medical University , Taichung , Taiwan.,b Department of Critical Care Medicine , Chung Shan Medical University Hospital , Taichung , Taiwan.,c Department of Nursing , Chung Shan Medical University Hospital , Taichung , Taiwan
| | - Jeng-Yuan Chiou
- d School of Health Policy and Management, Chung Shan Medical University , Taichung , Taiwan
| | - Jia-Yuh Chen
- a Institute of Medicine, Chung Shan Medical University , Taichung , Taiwan.,e School of Medicine, Chung Shan Medical University , Taichung , Taiwan , and.,f Department of Pediatrics , Chung Shan Medical University Hospital , Taichung , Taiwan
| | - Pen-Hua Su
- b Department of Critical Care Medicine , Chung Shan Medical University Hospital , Taichung , Taiwan.,e School of Medicine, Chung Shan Medical University , Taichung , Taiwan , and.,f Department of Pediatrics , Chung Shan Medical University Hospital , Taichung , Taiwan
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14
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Abstract
Chromosomal microarray analysis is a high-resolution, whole-genome technique used to identify chromosomal abnormalities, including those detected by conventional cytogenetic techniques, as well as small submicroscopic deletions and duplications referred to as copy number variants. Because chromosomal microarray analysis has a greater resolution than conventional karyotyping, it can detect deletions and duplications down to a 50- to 100-kb level. The purpose of this document is to discuss the technique, advantages, and disadvantages of chromosomal microarray analysis and its indications and limitations. We recommend the following: (1) that chromosomal microarray analysis be offered when genetic analysis is performed in cases with fetal structural anomalies and/or stillbirth and replaces the need for fetal karyotype in these cases (GRADE 1A); (2) that providers discuss the benefits and limitations of chromosomal microarray analysis and conventional karyotype with patients who are considering amniocentesis and chorionic villus sampling (CVS), and that both options should be available to women who choose to undergo diagnostic testing (GRADE 1B); (3) that pre- and posttest counseling should be performed by trained genetic counselors, geneticists, or other providers with expertise in the complexities of interpreting chromosomal microarray analysis results (Best Practice); (4) that patients be informed that chromosomal microarray analysis does not detect every genetic disease or syndrome and specifically does not detect autosomal-recessive disorders associated with single gene point mutations, as well as that chromosomal microarray analysis can detect consanguinity and nonpaternity in some cases (Best Practice); (5) that patients in whom a fetal variant of uncertain significance is detected by prenatal diagnosis receive counseling from experts who have access to databases that provide updated information concerning genotype-phenotype correlations (Best Practice).
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Affiliation(s)
- Lorraine Dugoff
- Society for Maternal-Fetal Medicine, 409 12 St. SW, Washington, DC 20024, USA.
| | - Mary E Norton
- Society for Maternal-Fetal Medicine, 409 12 St. SW, Washington, DC 20024, USA.
| | - Jeffrey A Kuller
- Society for Maternal-Fetal Medicine, 409 12 St. SW, Washington, DC 20024, USA.
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15
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Lawin O'Brien A, Dall'Asta A, Tapon D, Mann K, Ahn JW, Ellis R, Ogilvie C, Lees C. Gestation related karyotype, QF-PCR and CGH-array failure rates in diagnostic amniocentesis. Prenat Diagn 2016; 36:708-13. [PMID: 27192044 DOI: 10.1002/pd.4843] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 05/09/2016] [Accepted: 05/14/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Anna Lawin O'Brien
- Centre for Fetal Care; Queen Charlotte's and Chelsea Hospital, Imperial College; London UK
| | - Andrea Dall'Asta
- Centre for Fetal Care; Queen Charlotte's and Chelsea Hospital, Imperial College; London UK
- Department of Obstetrics and Gynaecology; University of Parma; Parma Italy
| | - Dagmar Tapon
- Centre for Fetal Care; Queen Charlotte's and Chelsea Hospital, Imperial College; London UK
| | - Kathy Mann
- Genetics Laboratories, Viapath Analytics; Guys and St Thomas' Hospital Foundation Trust; London UK
| | - Joo Wook Ahn
- Genetics Department; Guys and St Thomas' Hospital Foundation Trust; London UK
| | - Richard Ellis
- North West Thames Regional Genetics Service; London UK
| | - Caroline Ogilvie
- Genetics Department; Guys and St Thomas' Hospital Foundation Trust; London UK
- King's College; London UK
| | - Christoph Lees
- Centre for Fetal Care; Queen Charlotte's and Chelsea Hospital, Imperial College; London UK
- Department of Surgery and Cancer; Imperial College London; London UK
- Department of Development and Regeneration; KU Leuven; Belgium
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16
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Abstract
The choice of screening or invasive procedure in twin pregnancies is a personal choice of whether the patient wishes to take a small risk of having a baby with a serious disorder versus a small risk of having a complication because she wishes to avoid that. How to interpret such risks has profound effects on the perceived value of techniques, either leading to a decision to screening or going directly to chorionic villus sampling. There are profound issues surrounding the data and the interpretation of the data. No single short review can exhaustively examine all of the issues.
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Affiliation(s)
- Mark I Evans
- Fetal Medicine Foundation of America, USA; Comprehensive Genetics, 131 East 65th Street, New York, NY 10065, USA; Mt. Sinai School of Medicine, New York, NY, USA.
| | | | - Shara M Evans
- Comprehensive Genetics, 131 East 65th Street, New York, NY 10065, USA; University of Colorado, Aurora, CO, USA
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17
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Fetal Medicine in India: Taking Stock of 2015, and Planning for 2016 at the Journal of Fetal Medicine. JOURNAL OF FETAL MEDICINE 2016. [DOI: 10.1007/s40556-016-0079-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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18
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Abstract
Cell-free DNA (cfDNA) testing has recently become indispensable in diagnostic testing and screening. In the prenatal setting, this type of testing is often called noninvasive prenatal testing (NIPT). With a number of techniques, using either next-generation sequencing or single nucleotide polymorphism-based approaches, fetal cfDNA in maternal plasma can be analyzed to screen for rhesus D genotype, common chromosomal aneuploidies, and increasingly for testing other conditions, including monogenic disorders. With regard to screening for common aneuploidies, challenges arise when implementing NIPT in current prenatal settings. Depending on the method used (targeted or nontargeted), chromosomal anomalies other than trisomy 21, 18, or 13 can be detected, either of fetal or maternal origin, also referred to as unsolicited or incidental findings. For various biological reasons, there is a small chance of having either a false-positive or false-negative NIPT result, or no result, also referred to as a "no-call." Both pre- and posttest counseling for NIPT should include discussing potential discrepancies. Since NIPT remains a screening test, a positive NIPT result should be confirmed by invasive diagnostic testing (either by chorionic villus biopsy or by amniocentesis). As the scope of NIPT is widening, professional guidelines need to discuss the ethics of what to offer and how to offer. In this review, we discuss the current biochemical, clinical, and ethical challenges of cfDNA testing in the prenatal setting and its future perspectives including novel applications that target RNA instead of DNA.
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19
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Verma IC, Puri RD. Global burden of genetic disease and the role of genetic screening. Semin Fetal Neonatal Med 2015; 20:354-63. [PMID: 26251359 DOI: 10.1016/j.siny.2015.07.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
It is estimated that 5.3% of newborns will suffer from a genetic disorder, when followed up until the age of 25 years. In developing, as compared to western countries, hemoglobinopathies and glucose-6-phosphate dehydrogenase deficiency have a higher incidence due to severe falciparum malaria in the distant past, and autosomal recessive disorders have a higher frequency due to greater proportion of consanguineous marriages. Chromosomal disorders have a combined frequency of 1 in 153 births, therefore screening for chromosomal disorders is essential, using biochemical markers, ultrasonography, and recently by non-invasive prenatal diagnosis based on cell-free fetal DNA in maternal plasma. Preconceptional counseling should be encouraged. For genetic disorders screening should be carried out, ideally after marriage, but before pregnancy. The disorders to be screened depend upon ethnicity. Metabolic disorders have a high incidence in developing countries due to greater rate of consanguineous marriages. Newborn screening is recommended to reduce the burden of these disorders, as many metabolic disorders can be treated. Hearing and critical congenital heart disease should both be screened in the newborn period.
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Affiliation(s)
- I C Verma
- Center of Medical Genetics, Sir Ganga Ram Hospital, New Delhi, India.
| | - R D Puri
- Center of Medical Genetics, Sir Ganga Ram Hospital, New Delhi, India
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