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Zhu JJ, Qi H, Cai LR, Wen XH, Zeng W, Tang GD, Luo Y, Meng R, Mao XQ, Zhang SQ. C-banding and AgNOR-staining were still effective complementary methods to indentify chromosomal heteromorphisms and some structural abnormalities in prenatal diagnosis. Mol Cytogenet 2019; 12:41. [PMID: 31548869 PMCID: PMC6751659 DOI: 10.1186/s13039-019-0453-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 08/23/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In prenatal diagnosis, CMA has begun to emerge as a favorable alternative to karyotype analysis, but it could not identify balanced translocations, triploidies, inversion and heteromorphisms. Therefore, conventional cytogenetic and specific staining methods still play an important role in the work-up of chromosome anomaly. This study investigated the application of C-banding and AgNOR-staining techniques in prenatal diagnosis of chromosomal heteromorphisms and some structure abnormalities. RESULTS Among the 2970 samples, the incidence of chromosomal heteromorphisms was 8.79% (261/2970). The most frequent was found to be chromosome Y (2.93%, 87/2970), followed by chromosome 1 (1.65 %, 49/2970), 9 (1.52 %, 45/2970), 22 (0.77 %, 23/2970) and 15 (0.64 %, 19/2970). We compared the incidence of chromosomal heteromorphisms between recurrent spontaneous abortion (RSA) group and control group. The frequency of autosomal hetermorphisms in RSA group was 7.63% higher than that in control group (5.78%), while the frequency of Y chromosomal heteromorphisms was 4.76% lower than that in control group (5.71%). Here we summarized 4 representative cases, inv (1) (p12q24), psu dic (4;17) (p16.3;p13.3), r(X)(p11; q21) and an isodicentric bisatellited chromosome to illustrate the application of C-banding or AgNOR-staining, CMA or NGS was performed to detect CNVs if necessary. CONCLUSIONS This study indicated that C-banding and AgNOR-staining were still effective complementary methods to identify chromosomal heteromorphisms and marker chromosomes or some structural rearrangements involving the centromere or acrocentric chromosomes. Our results suggested that there was no evidence for an association between chromosomal heteromorphisms and infertility or recurrent spontaneous abortions. Undoubtedly, sometimes we needed to combine the results of CMA or CNV-seq to comprehensively reflect the structure and aberration of chromosome segments. Thus, accurate karyotype reports and genetic counseling could be provided.
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Affiliation(s)
- Jian Jiang Zhu
- Prenatal Diagnosis Center, Beijing Haidian Maternal and Child Health Hospital, Beijing, 100080 People’s Republic of China
| | - Hong Qi
- Prenatal Diagnosis Center, Beijing Haidian Maternal and Child Health Hospital, Beijing, 100080 People’s Republic of China
| | - Li Rong Cai
- Prenatal Diagnosis Center, Beijing Haidian Maternal and Child Health Hospital, Beijing, 100080 People’s Republic of China
| | - Xiao Hui Wen
- Prenatal Diagnosis Center, Beijing Haidian Maternal and Child Health Hospital, Beijing, 100080 People’s Republic of China
| | - Wen Zeng
- Prenatal Diagnosis Center, Beijing Haidian Maternal and Child Health Hospital, Beijing, 100080 People’s Republic of China
| | - Guo Dong Tang
- Prenatal Diagnosis Center, Beijing Haidian Maternal and Child Health Hospital, Beijing, 100080 People’s Republic of China
| | - Yao Luo
- Prenatal Diagnosis Center, Beijing Haidian Maternal and Child Health Hospital, Beijing, 100080 People’s Republic of China
| | - Ran Meng
- Prenatal Diagnosis Center, Beijing Haidian Maternal and Child Health Hospital, Beijing, 100080 People’s Republic of China
| | - Xue Qun Mao
- Prenatal Diagnosis Center, Beijing Haidian Maternal and Child Health Hospital, Beijing, 100080 People’s Republic of China
| | - Shao Qin Zhang
- Prenatal Diagnosis Center, Beijing Haidian Maternal and Child Health Hospital, Beijing, 100080 People’s Republic of China
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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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Zhang R, Chen X, Wang D, Chen X, Wang C, Zhang Y, Xu M, Yu J. Prevalence of chromosomal abnormalities identified by copy number variation sequencing in high-risk pregnancies, spontaneous abortions, and suspected genetic disorders. J Int Med Res 2019; 47:1169-1178. [PMID: 30732499 PMCID: PMC6421393 DOI: 10.1177/0300060518818020] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Objective High-throughput sequencing based on copy number variation (CNV-seq) is
commonly used to detect chromosomal abnormalities including aneuploidy. This
study provides evidence for the prevalence of chromosomal abnormalities in
target populations. Methods A total of 160 samples, including 83 high-risk pregnancies, 37 spontaneous
abortions, and 40 suspected genetic disorders, were analyzed by CNV-seq.
Relationships between the incidence of these chromosomal abnormalities and
risk factors (e.g. advanced maternal age, abnormal pregnancy history, and
family history of congenital disease) were further analyzed by subgroup. Results A total of 37 (44.6%) high-risk pregnancies, 25 (67.6%) spontaneous
abortions, and 22 (55%) suspected genetic disorders had chromosomal
abnormalities including aneuploidy and CNVs. There was an increased risk
association between the prevalence of aneuploidy and pathogenic-relevant CNV
in the fetus or abortive tissue and advanced maternal age. Moreover, a
family history of congenital disease was also positively correlated with
fetal chromosomal abnormalities in high-risk pregnancies. Conclusion A relatively high prevalence of chromosomal abnormalities was detected in
high-risk pregnancies, spontaneous abortions, and suspected genetic
disorders, indicating the importance of CNV detection in such
populations.
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Affiliation(s)
- Rui Zhang
- 1 Prenatal Diagnosis Center, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.,2 Scientific Research Centre, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | | | - Dong Wang
- 2 Scientific Research Centre, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xuan Chen
- 4 Department of Obstetrics, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Chao Wang
- 1 Prenatal Diagnosis Center, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yuhong Zhang
- 1 Prenatal Diagnosis Center, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | | | - Jingcui Yu
- 2 Scientific Research Centre, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
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Gonzalez C, Serrano MG, Barbancho Lopez C, Garcia-Riaño T, Barea Calero V, Moreno Perea R, Rodriguez Mogollón B, Queipo Rojas A, Climent AG, Cava Valenciano F. CGH Array and Karyotype as Complementary Tools in Prenatal Diagnosis: Prenatal Diagnosis of a 4q Derivative Chromosome from Maternal 4q;11q Translocation. Fetal Pediatr Pathol 2018; 37:184-190. [PMID: 29771170 DOI: 10.1080/15513815.2018.1467518] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
BACKGROUND There is controversy whether chromosomal microarray (CMA) can replace karyotyping in prenatal diagnosis. Chromosomal microarray may detect more clinically significant chromosomal imbalances than karyotyping in a shorter time but does not detect inversions, triploidies or low mosaicisms. CASE REPORT Amniocentesis was performed in the late second trimester based on ultrasound abnormalities. A CMA, obtained at 10 days, demonstrated a terminal deletion in 4q34.3-q35.2 and a duplication in 11q21-q25. The karyotype results, obtained 1 week later, showed a derivative chromosome 4 inherited from a maternal balanced 4;11 translocation. CONCLUSION CMA and karyotype were complementary in this case, together permitting a more accurate diagnosis and genetic counseling than if only one method was used.
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Affiliation(s)
- Cristina Gonzalez
- a Genetics Department , Hospital Universitario Infanta Sofia , San Sebastian de los Reyes , Madrid , Spain
| | - Miriam Gutierrez Serrano
- a Genetics Department , Hospital Universitario Infanta Sofia , San Sebastian de los Reyes , Madrid , Spain
| | - Carmen Barbancho Lopez
- b Gynecology and Obstretics Department , Hospital Universitario Infanta Sofia , San Sebastian de los Reyes , Madrid , Spain
| | - Taida Garcia-Riaño
- b Gynecology and Obstretics Department , Hospital Universitario Infanta Sofia , San Sebastian de los Reyes , Madrid , Spain
| | - Vanesa Barea Calero
- a Genetics Department , Hospital Universitario Infanta Sofia , San Sebastian de los Reyes , Madrid , Spain
| | - Rebeca Moreno Perea
- a Genetics Department , Hospital Universitario Infanta Sofia , San Sebastian de los Reyes , Madrid , Spain
| | - Begoña Rodriguez Mogollón
- a Genetics Department , Hospital Universitario Infanta Sofia , San Sebastian de los Reyes , Madrid , Spain
| | - Amelia Queipo Rojas
- a Genetics Department , Hospital Universitario Infanta Sofia , San Sebastian de los Reyes , Madrid , Spain
| | - Ana Garcia Climent
- c CIALAB, Genetics , Calle Cristo de la Paz, San Juan de Alicante , Alicante , Spain
| | - Fernando Cava Valenciano
- d Clinical Laboratory , Hospital Universitario Infanta Sofia , San Sebastian de los Reyes , Madrid , Spain
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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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Govaerts L, Srebniak M, Diderich K, Joosten M, Riedijk S, Knapen M, Go A, Papatsonis D, de Graaf K, Toolenaar T, van der Steen S, Huijbregts G, Knijnenburg J, de Vries F, Van Opstal D, Galjaard RJ. Prenatal diagnosis of susceptibility loci for neurodevelopmental disorders - genetic counseling and pregnancy outcome in 57 cases. Prenat Diagn 2016; 37:73-80. [DOI: 10.1002/pd.4979] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 11/15/2016] [Accepted: 11/26/2016] [Indexed: 12/23/2022]
Affiliation(s)
- Lutgarde Govaerts
- Department of Clinical Genetics; Erasmus Medical Center; Rotterdam The Netherlands
| | - Malgorzata Srebniak
- Department of Clinical Genetics; Erasmus Medical Center; Rotterdam The Netherlands
| | - Karin Diderich
- Department of Clinical Genetics; Erasmus Medical Center; Rotterdam The Netherlands
| | - Marieke Joosten
- Department of Clinical Genetics; Erasmus Medical Center; Rotterdam The Netherlands
| | - Sam Riedijk
- Department of Clinical Genetics; Erasmus Medical Center; Rotterdam The Netherlands
| | - Maarten Knapen
- Department of Obstetrics and Gynecology; Erasmus Medical Center; Rotterdam The Netherlands
- Foundation Prenatal Screening Southwest region of the Netherlands; Rotterdam The Netherlands
| | - Attie Go
- Department of Obstetrics and Gynecology; Erasmus Medical Center; Rotterdam The Netherlands
| | - Dimitri Papatsonis
- Department of Obstetrics and Gynecology; Amphia Hospital; Breda The Netherlands
| | - Katja de Graaf
- Department of Obstetrics and Gynecology; Reinier de Graaf Gasthuis; Delft The Netherlands
| | - Toon Toolenaar
- Department of Gynecology; Albert Schweitzer Hospital Dordrecht; Dordrecht The Netherlands
| | - Sanne van der Steen
- Department of Clinical Genetics; Erasmus Medical Center; Rotterdam The Netherlands
| | - Gido Huijbregts
- Department of Clinical Genetics; Erasmus Medical Center; Rotterdam The Netherlands
| | - Jeroen Knijnenburg
- Department of Clinical Genetics; Erasmus Medical Center; Rotterdam The Netherlands
| | - Femke de Vries
- Department of Clinical Genetics; Erasmus Medical Center; Rotterdam The Netherlands
| | - Diane Van Opstal
- Department of Clinical Genetics; Erasmus Medical Center; Rotterdam The Netherlands
| | - Robert-Jan Galjaard
- Department of Clinical Genetics; Erasmus Medical Center; Rotterdam The Netherlands
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Calonico E, Blumenfeld YJ, Hudgins L, Taylor J. Patient preferences for prenatal testing of microdeletion and microduplication syndromes. Prenat Diagn 2016; 36:244-51. [DOI: 10.1002/pd.4760] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Revised: 11/04/2015] [Accepted: 12/10/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Elise Calonico
- Department of Genetics; Stanford University School of Medicine; Stanford CA USA
| | - Yair J. Blumenfeld
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine; Stanford University School of Medicine; Stanford CA USA
- Lucile Packard Children's Hospital Stanford; Palo Alto CA USA
| | - Louanne Hudgins
- Lucile Packard Children's Hospital Stanford; Palo Alto CA USA
- Department of Pediatrics, Division of Medical Genetics; Stanford University School of Medicine; Stanford CA USA
| | - Joanne Taylor
- Lucile Packard Children's Hospital Stanford; Palo Alto CA USA
- Department of Pediatrics, Division of Medical Genetics; Stanford University School of Medicine; Stanford CA USA
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Srebniak MI, Van Opstal D, Joosten M, Diderich KEM, de Vries FAT, Riedijk S, Knapen MFCM, Go ATJI, Govaerts LCP, Galjaard RJH. Whole-genome array as a first-line cytogenetic test in prenatal diagnosis. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2015; 45:363-372. [PMID: 25488734 DOI: 10.1002/uog.14745] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 11/17/2014] [Accepted: 11/21/2014] [Indexed: 06/04/2023]
Affiliation(s)
- M I Srebniak
- Department of Clinical Genetics, Erasmus Medical Centre, Rotterdam, The Netherlands
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