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Moerdijk AS, Claessens NH, van Ooijen IM, van Ooij P, Alderliesten T, Grotenhuis HB, Benders MJNL, Bohte AE, Breur JMPJ, Charisopoulou D, Clur SA, Cornette JMJ, Fejzic Z, Franssen MTM, Frerich S, Geerdink LM, Go ATJI, Gommers S, Helbing WA, Hirsch A, Holtackers RJ, Klein WM, Krings GJ, Lamb HJ, Nijman M, Pajkrt E, Planken RN, Schrauben EM, Steenhuis TJ, ter Heide H, Vanagt WYR, van Beynum IM, van Gaalen MD, van Iperen GG, van Schuppen J, Willems TP, Witters I. Fetal MRI of the heart and brain in congenital heart disease. Lancet Child Adolesc Health 2023; 7:59-68. [PMID: 36343660 DOI: 10.1016/s2352-4642(22)00249-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/12/2022] [Accepted: 08/22/2022] [Indexed: 11/06/2022]
Abstract
Antenatal assessment of congenital heart disease and associated anomalies by ultrasound has improved perinatal care. Fetal cardiovascular MRI and fetal brain MRI are rapidly evolving for fetal diagnostic testing of congenital heart disease. We give an overview on the use of fetal cardiovascular MRI and fetal brain MRI in congenital heart disease, focusing on the current applications and diagnostic yield of structural and functional imaging during pregnancy. Fetal cardiovascular MRI in congenital heart disease is a promising supplementary imaging method to echocardiography for the diagnosis of antenatal congenital heart disease in weeks 30-40 of pregnancy. Concomitant fetal brain MRI is superior to brain ultrasound to show the complex relationship between fetal haemodynamics in congenital heart disease and brain development.
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Affiliation(s)
- Anouk S Moerdijk
- Department of Pediatric Cardiology, Division of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands
| | - Nathalie Hp Claessens
- Department of Pediatric Cardiology, Division of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands; Department of Neonatology, Division of Woman and Baby, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands
| | - Inge M van Ooijen
- Department of Neonatology, Division of Woman and Baby, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands
| | - Pim van Ooij
- Department of Pediatric Cardiology, Division of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands
| | - Thomas Alderliesten
- Department of Pediatric Cardiology, Division of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands; Department of Neonatology, Division of Woman and Baby, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands
| | - Heynric B Grotenhuis
- Department of Pediatric Cardiology, Division of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands.
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Pietersma CS, Mulders AGMGJ, Moolenaar LM, Hunink MGM, Koning AHJ, Willemsen SP, Go ATJI, Steegers EAP, Rousian M. First trimester anomaly scan using virtual reality (VR FETUS study): study protocol for a randomized clinical trial. BMC Pregnancy Childbirth 2020; 20:515. [PMID: 32894073 PMCID: PMC7487721 DOI: 10.1186/s12884-020-03180-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 08/14/2020] [Indexed: 02/08/2023] Open
Abstract
Background In recent years it has become clear that fetal anomalies can already be detected at the end of the first trimester of pregnancy by two-dimensional (2D) ultrasound. This is why increasingly in developed countries the first trimester anomaly scan is being offered as part of standard care. We have developed a Virtual Reality (VR) approach to improve the diagnostic abilities of 2D ultrasound. Three-dimensional (3D) ultrasound datasets are used in VR assessment, enabling real depth perception and unique interaction. The aim of this study is to investigate whether first trimester 3D VR ultrasound is of additional value in terms of diagnostic accuracy for the detection of fetal anomalies. Health-related quality of life, cost-effectiveness and also the perspective of both patient and ultrasonographer on the 3D VR modality will be studied. Methods Women in the first trimester of a high risk pregnancy for a fetus with a congenital anomaly are eligible for inclusion. This is a randomized controlled trial with two intervention arms. The control group receives ‘care as usual’: a second trimester 2D advanced ultrasound examination. The intervention group will undergo an additional first trimester 2D and 3D VR ultrasound examination. Following each examination participants will fill in validated questionnaires evaluating their quality of life and healthcare related expenses. Participants’ and ultrasonographers’ perspectives on the 3D VR ultrasound will be surveyed. The primary outcome will be the detection of fetal anomalies. The additional first trimester 3D VR ultrasound examination will be compared to ‘care as usual’. Neonatal or histopathological examinations are considered the gold standard for the detection of congenital anomalies. To reach statistical significance and 80% power with a detection rate of 65% for second trimester ultrasound examination and 70% for the combined detection of first trimester 3D VR and second trimester ultrasound examination, a sample size of 2800 participants is needed. Discussion First trimester 3D VR detection of fetal anomalies may improve patients’ quality of life through reassurance or earlier identification of malformations. Results of this study will provide policymakers and healthcare professionals with the highest level of evidence for cost-effectiveness of first trimester ultrasound using a 3D VR approach. Trial registration Dutch Trial Registration number NTR6309, date of registration 26 January 2017.
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Affiliation(s)
- C S Pietersma
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - A G M G J Mulders
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - L M Moolenaar
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - M G M Hunink
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, the Netherlands.,Department of Radiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, USA
| | - A H J Koning
- Department of Pathology, Clinical Bioinformatics Unit, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - S P Willemsen
- Department of Biostatistics, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - A T J I Go
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - E A P Steegers
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - M Rousian
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, the Netherlands.
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Srebniak MI, Joosten M, Knapen MFCM, Arends LR, Polak M, van Veen S, Go ATJI, Van Opstal D. Frequency of submicroscopic chromosomal aberrations in pregnancies without increased risk for structural chromosomal aberrations: systematic review and meta-analysis. Ultrasound Obstet Gynecol 2018; 51:445-452. [PMID: 28556491 DOI: 10.1002/uog.17533] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 05/08/2017] [Accepted: 05/18/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To establish, based on a systematic literature review, the frequency of pathogenic submicroscopic chromosomal aberrations in fetuses that are not at increased risk for unbalanced structural chromosomal aberrations, with the aim of determining whether high-resolution testing for submicroscopic aberrations is beneficial in a general pregnant population. METHODS EMBASE, PubMed, Web of Science and CENTRAL databases were searched systematically on 3 June 2016 for all relevant articles on the prevalence of pathogenic submicroscopic copy number variants (CNVs) in fetuses referred for prenatal invasive testing because of advanced maternal age (AMA) or parental anxiety (ANX). Relevant full-text articles were analyzed and the prevalence of submicroscopic CNVs was calculated based on the extracted data. Meta-analysis was conducted in a pooled cohort of 10 614 fetuses based on the 10 largest studies (n > 300) of a total of 19 that were relevant. RESULTS Pooled estimate analysis indicated that 0.84% (95% CI, 0.55-1.30%) of fetuses that had invasive testing because of AMA/ANX carried a pathogenic clinically significant submicroscopic aberration. The onset/penetrance of submicroscopic findings was studied in 10 314 fetuses reported in eight papers that presented aberrant cases with all necessary details to allow assessment of the findings. The pooled estimates resulting from meta-analysis of the data indicated that an early-onset syndromic disorder was detected in 0.37% (95% CI, 0.27-0.52%) of cases, a susceptibility CNV was found in 0.30% (95% CI, 0.14-0.67%) and late-onset diseases were reported in 0.11% (95% CI, 0.05%-0.21%). The prevalence of early-onset syndromic disorders caused by a submicroscopic aberration was calculated to be 1:270. When the risk for submicroscopic aberrations is added to the individual risk for microscopic chromosomal aberrations, all pregnant women have a risk of higher than 1 in 180 for a relevant chromosomal aberration, and pregnant women under 36 years of age have a higher risk for submicroscopic pathogenic aberrations than for Down syndrome. CONCLUSION This systematic review shows that a significant proportion of fetuses in a general pregnant population carry a submicroscopic pathogenic CNV. Based on these figures, all women should be informed on their individual risk for all pathogenic chromosomal aberrations and not only for common trisomies. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- M I Srebniak
- Department of Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands
| | - M Joosten
- Department of Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands
| | - M F C M Knapen
- Department of Obstetrics and Gynecology, Erasmus MC, Rotterdam, The Netherlands
- Foundation Prenatal Screening Southwest Region of the Netherlands, Rotterdam, The Netherlands
| | - L R Arends
- Department of Psychology, Education & Child Studies (DPECS), Erasmus University Rotterdam, Rotterdam, The Netherlands
- Department of Biostatistics, Erasmus MC, Rotterdam, The Netherlands
| | - M Polak
- Department of Psychology, Education & Child Studies (DPECS), Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - S van Veen
- Department of Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands
| | - A T J I Go
- Department of Obstetrics and Gynecology, Erasmus MC, Rotterdam, The Netherlands
| | - D Van Opstal
- Department of Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands
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de Wit MC, Boekhorst F, Mancini GM, Smit LS, Groenenberg IAL, Dudink J, de Vries FAT, Go ATJI, Galjaard RJH. Advanced genomic testing may aid in counseling of isolated agenesis of the corpus callosum on prenatal ultrasound. Prenat Diagn 2017; 37:1191-1197. [PMID: 28921563 DOI: 10.1002/pd.5158] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 09/06/2017] [Accepted: 09/11/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Isolated agenesis of the corpus callosum on fetal ultrasound has a varied prognosis. Microarray and exome sequencing (ES) might aid in prenatal counseling. METHOD This study includes 25 fetuses with apparently isolated complete corpus callosum (cACC) on ultrasound. All cases were offered single nucleotide polymorphism array. Complementary ES was offered postnatally in selected cases. Clinical physical and neurodevelopmental follow-up was collected. RESULTS Eighteen cases opted for single nucleotide polymorphism array testing, which detected a causal anomaly in 2/18 (11.1%; 95% CI 2.0%-31%). Among ongoing pregnancies without a causal anomaly on microarray, 30% (95% CI 8.5%-60%) showed intellectual disability. Postnatal magnetic resonance imaging and physical examination often (64%; 95% CI 38%-85%, and 64%; 95% CI 38%-85%, respectively) revealed additional physical anomalies in cases without a causal anomaly on microarray. Two cases appeared truly isolated after birth. Postnatal sequencing in 4 of 16 cases without a causal anomaly on microarray but with intellectual disability and/or additional postnatal physical anomalies revealed 2 single-gene disorders. Therefore, the estimated diagnostic yield of ES in chromosomally normal cACC fetuses is between 2/4 (50%; 95% CI 11%-89%) and 2/16 (13.3%; 95% CI 2.4%-36%). CONCLUSION In accordance with current guidelines, we conclude that microarray should be offered in case of isolated cACC on ultrasound. ES is likely to be informative for prenatal counseling and should be offered if microarray is normal.
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Affiliation(s)
- M C de Wit
- Department of Obstetrics and Gynecology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - F Boekhorst
- Department of Obstetrics and Gynecology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - G M Mancini
- Department of Clinical Genetics, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - L S Smit
- Department of Neurology, Division of Pediatric Neurology, Erasmus Medical Centre, University Medical Centre, Rotterdam, the Netherlands.,Department of Pediatrics, Division of Neonatology, Erasmus Medical Centre and Sophia Children's Hospital, Rotterdam, the Netherlands
| | - I A L Groenenberg
- Department of Obstetrics and Gynecology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - J Dudink
- Department of Pediatrics, Division of Neonatology, Erasmus Medical Centre and Sophia Children's Hospital, Rotterdam, the Netherlands.,Department of Neonatology, Wilhelmina Children's Hospital, UMC Utrecht, Utrecht, the Netherlands
| | - F A T de Vries
- Department of Clinical Genetics, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - A T J I Go
- Department of Obstetrics and Gynecology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - R J H Galjaard
- Department of Clinical Genetics, Erasmus Medical Centre, Rotterdam, the Netherlands
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de Wit MC, Bunnik EM, Go ATJI, de Beaufort ID, Hofstra RMW, Steegers EAP, Galjaard RJH. Amniocentesis is still the best option for advanced genomic testing in case of fetal malformations. Prenat Diagn 2017; 37:1360-1363. [PMID: 29149523 DOI: 10.1002/pd.5187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 11/05/2017] [Accepted: 11/07/2017] [Indexed: 11/09/2022]
Affiliation(s)
- M C de Wit
- Department of Obstetrics and Gynecology, Erasmus Medical Centre and Sophia Children's Hospital, Rotterdam, The Netherlands
| | - E M Bunnik
- Department of Medical Ethics and Philosophy of Medicine, Erasmus Medical Centre and Sophia Children's Hospital, Rotterdam, Rotterdam, The Netherlands
| | - A T J I Go
- Department of Obstetrics and Gynecology, Erasmus Medical Centre and Sophia Children's Hospital, Rotterdam, The Netherlands
| | - I D de Beaufort
- Department of Medical Ethics and Philosophy of Medicine, Erasmus Medical Centre and Sophia Children's Hospital, Rotterdam, Rotterdam, The Netherlands
| | - R M W Hofstra
- Department of Clinical Genetics, Erasmus Medical Centre and Sophia Children's Hospital, Rotterdam, The Netherlands
| | - E A P Steegers
- Department of Obstetrics and Gynecology, Erasmus Medical Centre and Sophia Children's Hospital, Rotterdam, The Netherlands
| | - R J H Galjaard
- Department of Clinical Genetics, Erasmus Medical Centre and Sophia Children's Hospital, Rotterdam, The Netherlands
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de Wit MC, Srebniak MI, Joosten M, Govaerts LCP, Kornelisse RF, Papatsonis DNM, de Graaff K, Knapen MFCM, Bruggenwirth HT, de Vries FAT, Van Veen S, Van Opstal D, Galjaard RJH, Go ATJI. Prenatal and postnatal findings in small-for-gestational-age fetuses without structural ultrasound anomalies at 18-24 weeks. Ultrasound Obstet Gynecol 2017; 49:342-348. [PMID: 27102944 DOI: 10.1002/uog.15949] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 03/09/2016] [Accepted: 04/15/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To assess phenotypic and genotypic characteristics of small-for-gestational-age (SGA) fetuses without structural anomalies at 18-24 weeks' gestation. METHODS This retrospective study included structurally normal singleton fetuses with an abdominal circumference ≤ 5th percentile on detailed ultrasound examination between 18 and 24 weeks' gestation. Cases were stratified according to the absence or presence of other abnormal ultrasound findings, such as abnormal amniotic fluid or soft markers. All patients were offered invasive prenatal testing with rapid aneuploidy detection by qualitative fluorescence polymerase chain reaction (QF-PCR) and, if normal, consecutive single nucleotide polymorphism (SNP) array was also offered. Detailed postnatal follow-up (≥ 5 months) was performed. In cases in which a syndromic phenotype became apparent within 5 months after birth and SNP array had not been performed prenatally, it was performed postnatally. RESULTS A total of 211 pregnancies were eligible for inclusion. Of the 158 cases with isolated SGA on ultrasound, 36 opted for invasive prenatal testing. One case of trisomy 21 and one case of a submicroscopic abnormality (a susceptibility locus for neurodevelopmental disease) were detected. Postnatal follow-up showed a postnatal apparent syndromic phenotype in 10 cases. In one case this was due to trisomy 21 and the other nine (5.8%; 95% CI, 2.8-10.0%) cases had normal SNP array results. In 32/53 cases with SGA and associated ultrasound abnormalities, parents opted for invasive testing. One case of trisomy 21 and one of triploidy were found. In 11 cases a syndromic phenotype became apparent after birth. One was due to trisomy 21 and in one case a submicroscopic anomaly (a susceptibility locus) was found. The remaining syndromic cases (17.3%; 95% CI, 8.7-29.0%) had normal SNP array results. CONCLUSION Testing for chromosomal anomalies should be offered in cases of SGA between 18 and 24 weeks' gestation. Whole chromosome anomalies occur in 1.3% (95% CI, 0.2-3.9%) of isolated SGA and 5.8% (95% CI, 1.5-14.0%) of associated SGA. In 0.6% (95% CI, 0.1-2.8%) and 1.9% (95% CI, 0.2-8.2%), respectively, SNP array detected a susceptibility locus for neurodevelopmental disease that would not be detected by karyotyping, QF-PCR or non-invasive prenatal testing. Therefore, and because the genetic causes of SGA are diverse, we suggest SNP array testing in cases of SGA. Thorough postnatal examination and follow-up of infants that presented with reduced fetal growth is important because chromosomally normal syndromic phenotypes occur frequently in SGA fetuses. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- M C de Wit
- Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - M I Srebniak
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - M Joosten
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - L C P Govaerts
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - R F Kornelisse
- Department of Neonatology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - D N M Papatsonis
- Department of Obstetrics and Gynecology, Amphia Hospital, Breda, The Netherlands
| | - K de Graaff
- Department of Obstetrics and Gynecology, Reinier de Graaf Groep, Delft, The Netherlands
| | - M F C M Knapen
- Foundation Prenatal Screening Southwestern region of The Netherlands, Rotterdam, The Netherlands
| | - H T Bruggenwirth
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - F A T de Vries
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - S Van Veen
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - D Van Opstal
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - R J H Galjaard
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - A T J I Go
- Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, The Netherlands
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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 Obstet Gynecol 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] [What about the content of this article? (0)] [Affiliation(s)] [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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de Wit MC, Srebniak MI, Govaerts LCP, Van Opstal D, Galjaard RJH, Go ATJI. Additional value of prenatal genomic array testing in fetuses with isolated structural ultrasound abnormalities and a normal karyotype: a systematic review of the literature. Ultrasound Obstet Gynecol 2014; 43:139-146. [PMID: 23897843 DOI: 10.1002/uog.12575] [Citation(s) in RCA: 108] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/19/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To establish the prevalence of submicroscopic genetic copy number variants (CNVs) in fetuses with a structural ultrasound anomaly (restricted to one anatomical system) and a normal karyotype. The aim was to determine the diagnostic and prognostic value of genomic array testing in these pregnancies. METHODS Embase and PubMed databases were systematically searched for all relevant articles on prevalence of pathogenic submicroscopic CNVs in fetuses with ultrasound anomalies. Reported cases were sorted into groups according to anatomical site of the detected ultrasound anomaly. The prevalence of causative submicroscopic CNVs was calculated for each group. RESULTS Combined data of the reviewed studies (n = 18) indicated that fetuses with an ultrasound anomaly restricted to one anatomical system (n = 2220) had a 3.1-7.9% chance of carrying a causative submicroscopic CNV, depending on the anatomical system affected. This chance increased to 9.1% for fetuses with multiple ultrasound anomalies (n = 1139). CONCLUSION This review indicates that 3.1-7.9% of fetuses with a structural ultrasound anomaly restricted to one anatomical system and a normal karyotype will show a submicroscopic CNV, which explains its phenotype and provides information for fetal prognosis. Therefore, we conclude that microarray has considerable diagnostic and prognostic value in these pregnancies.
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Affiliation(s)
- M C de Wit
- Department of Obstetrics and Gynecology, Erasmus Medical Centre, Rotterdam, The Netherlands
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Bogers H, Cohen-Overbeek TE, Go ATJI. Parvovirus B19 infection in pregnancy and amniocentesis. Prenat Diagn 2011; 31:1109; author reply 1110. [PMID: 22021006 DOI: 10.1002/pd.2773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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10
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Hack KEA, Derks JB, Elias SG, van Mameren FA, Koopman-Esseboom C, Mol BWJ, Lopriore E, Schaap AHP, Arabin B, Duvekot JJ, Go ATJI, Wieselmann E, Eggink AJ, Willekes C, Vandenbussche FPHA, Visser GHA. Perinatal mortality and mode of delivery in monochorionic diamniotic twin pregnancies ≥ 32 weeks of gestation: a multicentre retrospective cohort study. BJOG 2011; 118:1090-7. [PMID: 21585638 DOI: 10.1111/j.1471-0528.2011.02955.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To study perinatal mortality rates in a cohort of 465 monochorionic (MC) twins without twin-twin transfusion syndrome (TTS) born at 32 weeks of gestation or later since reported interauterine fetal death (IUFD) rates >32 weeks of gestations in the literature vary, leading to varying recommendations on the optimal timing of delivery, and to investigate the relation between perinatal mortality and mode of delivery. DESIGN Multicentre retrospective cohort study. SETTING Ten perinatal referral centres in the Netherlands. POPULATION All MC twin pregnancies without TTTS delivered at ≥ 32 weeks of gestation between January 2000 and December 2005. METHODS The medical records of all MC twin pregnancies without TTTS delivered at the ten perinatal referral centres in the Netherlands between January 2000 and December 2005 were reviewed. MAIN OUTCOME MEASURES Perinatal mortality in relation to gestational age and mode of delivery at ≥ 32 weeks of gestation. RESULTS After 32 weeks of gestation, five out of 930 fetuses died in utero and there were six neonatal deaths (6 per 1000 infants). In women who delivered ≥ 37 weeks, perinatal mortality was 7 per 1000 infants. Trial of labour was attempted in 376 women and was successful in 77%. There were three deaths in deliveries with a trial of labour (8 per 1000 deliveries), of which two were related to mode of delivery. Infants born by caesarean section without labour had an increased risk of neonatal morbidity and respiratory distress syndrome. CONCLUSIONS In MC twin pregnancies the incidence of intrauterine fetal death is low ≥ 32 weeks of gestation. Therefore, planned preterm delivery before 36 weeks does not seem to be justified. The risk of intrapartum death is also low, at least in tertiary centres.
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Affiliation(s)
- K E A Hack
- Department of Obstetrics, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, the Netherlands.
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Houweling AC, de Mooij YM, van der Burgt I, Yntema HG, Lachmeijer AMA, Go ATJI. Prenatal detection of Noonan syndrome by mutation analysis of the PTPN11 and the KRAS genes. Prenat Diagn 2010; 30:284-6. [PMID: 20112233 DOI: 10.1002/pd.2458] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Go ATJI, Visser A, Mulders MAM, Twisk JWR, Blankenstein MA, van Vugt JMG, Oudejans CBM. C21ORF105, A chromosome 21-encoded mRNA, is not a discriminative marker gene for prediction of Down syndrome in maternal plasma. Prenat Diagn 2007; 27:146-9. [PMID: 17186567 DOI: 10.1002/pd.1637] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The presence and detectability of placental mRNA in maternal plasma opens possibilities for the development of non-invasive prenatal diagnostic tests. In this study, we tested C21orf105, a chromosome 21-encoded, placentally expressed gene, in maternal plasma of women carrying a fetus with or without trisomy 21. METHODS Using real-time RT-PCR, we determined transcript levels of target (C21orf105) and reference (hPL) genes in first-trimester plasma samples. Plasma was obtained from first-trimester EDTA blood after two sequential centrifugation steps and stored at -70 degrees C. After RNA extraction, quantitative RT-PCR was performed using Taqman probes. RESULTS From the 51 samples, 43 samples were conclusive. Comparison of transcript levels of C21orf105 in both groups showed no significant differences. When expressed as ratios of hPL/C21orf105, the differences between trisomy 21 and normal pregnancies remained non-significant. CONCLUSIONS The amount of C21orf105 mRNA in maternal plasma, although situated in the Down syndrome critical region on chromosome 21 and up regulated in trisomy 21 placentas, is not higher in women carrying a fetus with trisomy 21.
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Affiliation(s)
- A T J I Go
- Department of Obstetrics/Gynecology, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
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Go ATJI, Hupkes HWD, Lomecky M, Twisk J, Blankenstein JM, van Vugt JMG. [Evaluation of a programme for the prenatal screening for Down's syndrome by ultrasonographic nuchal translucency measurement and serum determinations in the first trimester of pregnancy]. Ned Tijdschr Geneeskd 2005; 149:2795-9. [PMID: 16385832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVE To determine the diagnostic value of the combination screening test for Down's syndrome in women in the first trimester of pregnancy. DESIGN Secondary data analysis. METHOD The data from 2026 consecutive combination tests that were carried out in the period 1 May 2001-31 October 2003 in the VU Medical Centre in Amsterdam, The Netherlands, were analysed. The combination test comprised ultrasonographic neck fold measurement together with determination of the serum levels of free human beta-chorionic gonadotrophin and pregnancy-associated plasma protein A. The chance of Down's syndrome in the foetus was calculated using the median values of the Fetal Medicine Foundation (FMF) and medians based on the population in the VU Medical Centre. A chance > or = 1:200 was considered elevated. Follow-up data were collected from the medical records and from patient reports. RESULTS The data from 25 patients were excluded because of incompleteness of the investigation or the presence of diabetes mellitus in the pregnant subject. Follow-up data were obtained from 1759 of the 2001 remaining women (88%). Of the 1759 women, 49% were < or = 35 years old and 51% were > or = 36 years of age. Down's syndrome was diagnosed in 21 pregnancies, 16 of which were in the advanced maternal age group of patients. The detection percentage of Down's syndrome by nuchal translucency measurement was 67 with 3 false-positives when calculated on the basis of the FMF-medians and 76 with 6 false-positives when calculated on the basis of the VU Medical Centre medians. With the combination test, the detection percentage of Down's syndrome was 86 with 11 false-positives when calculated on the basis of the FMF-medians and 90 with 5 false-positives when calculated on the basis of the VU Medical Centre medians. CONCLUSION The diagnostic value of the first-trimester combination test was greater than that of only nuchal translucency measurement. Moreover, the diagnostic value was greater if the chances were calculated on the basis of the median values of the VU Medial Centre population than when other median values were used.
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Affiliation(s)
- A T J I Go
- Afd. Verloskunde en Gynaecologie, VU Medisch Centrum, Postbus 7057, 1007 MB Amsterdam
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