Turner syndrome-omphalocele association: Incidence, karyotype, phenotype and fetal outcome

OBJECTIVE

Omphalocele is known to be associated with genetic anomalies like trisomy 13, 18 and Beckwith-Wiedemann syndrome, but not with Turner syndrome (TS). Our aim was to assess the incidence of omphalocele in fetuses with TS, the phenotype of this association with other anomalies, their karyotype, and the fetal outcomes.

METHOD

Retrospective multicenter study of fetuses with confirmed diagnosis of TS. Data were extracted from a detailed questionnaire sent to specialists in prenatal ultrasound.

RESULTS

680 fetuses with TS were included in this analysis. Incidence of small omphalocele in fetuses diagnosed ≥12 weeks was 3.1%. Including fetuses diagnosed before 12 weeks, it was 5.1%. 97.1% (34/35) of the affected fetuses had one or more associated anomalies including increased nuchal translucency (≥3 mm) and/or cystic hygroma (94.3%), hydrops/skin edema (71.1%), and cardiac anomalies (40%). The karyotype was 45,X in all fetuses. Fetal outcomes were poor with only 1 fetus born alive.

CONCLUSION

TS with 45,X karyotype but not with X chromosome variants is associated with small omphalocele. Most of these fetuses have associated anomalies and a poor prognosis. Our data suggest an association of TS with omphalocele, which is evident from the first trimester.

Prenatal diagnosis of sex chromosome aneuploidy-What do we tell the prospective parents?

Sex chromosome aneuploidy (SCA) can be detected on prenatal diagnostic testing and cell free DNA screening (cfDNA). High risk cfDNA results should be confirmed with diagnostic testing. This summary article serves as an update for prenatal providers and assimilates data from neurodevelopmental, epidemiologic, and registry studies on the most common SCA. This information can be helpful for counseling after prenatal diagnosis of sex chromosome aneuploidy. Incidence estimates may be influenced by ascertainment bias and this article is not a substitute for interdisciplinary consultation and counseling.

Detection of turner syndrome using hand X-ray using anchor based links segmentation method

Turner Syndrome (TS) is a chromosomal disorder, wherein the female's growth is impacted. Immature ovaries, low stature, and heart abnormalities are a range of developmental and medical issues due to TS. The condition of TS might be detected prior to birth, throughout infancy or in the early years of life. The diagnosis of TS in girls with modest symptoms and indications is sometimes deferred until they reach adolescence or become young adults. This study presents an algorithm to segment the hand digital X-ray image in children with TS. In medical image and computer vision examination, image segmentation is demanding, and very crucial. Prevailing segmentation algorithms even now suffer from common segmentation issues including under-segmentation, over-segmentation, and spurious or non-closed edges, regardless of the several years of studies. In this paper, Anchor Based Link (ABL) segmentation approach is proposed to detect TS based on fourth Metacarpal bone from left hand X-ray images. The detection of TS is demonstrated based upon the comparison of proposed approach with existing watershed segmentation and Gaussian-Mixture-Model-based Hidden-Markov-Random-Field (GMM-HMRF) method. The proposed approach attains better segmentation based on the ratio of height and width of left fourth finger that is analyzed for normal children and children having TS with the help of edge pixel present in the metacarpal bone that has been segmented. The suggested method is verified on fifty (50) sample X-ray hand images of carpal bones, providing 0.60 ± 0.02 as an average Dice coefficient.