E-ISSN: 2619-9467

Contents    Cover    Publication Date: 28 Mar 2019
Year 2019 - Volume 29 - Issue 1

Open Access

Peer Reviewed

ORIGINAL RESEARCH
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Evaluation of Invasive Prenatal Test Indications and Results at a Tertiary Center in the Thrace Region of Turkey

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J Clin Obstet Gynecol. 2019;29(1):8-16
DOI: 10.5336/jcog.2018-64193
Article Language: EN
Copyright Ⓒ 2024 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: The present study aimed at evaluating and improving the knowledge regarding prenatal test indications by assessing the results of the invasive prenatal tests for the detection of fetal chromosomal anomalies conducted in our tertiary center. Material and Methods: A retrospective study was conducted to collect the results of prenatal invasive procedures performed in our tertiary center between January 2002-September 2017. The types and prevalence of fetal chromosomal anomalies were identified and the efficiency of the invasive procedure indications in predicting these fetal chromosomal anomalies was investigated. Results: The results of 2136 invasive procedures (2014 amniocentesis, 80 cordocentesis, and 42 chorion villus samplings) revealed 101 (4.72%) fetal chromosomal anomalies and 128 (5.99%) chromosomal polymorphisms. The most common chromosomal anomaly observed was trisomy 21 (n=52), followed by trisomy 18 (n=12). In terms of diagnosis of the fetal chromosomal anomalies, the following observations were made: the indication "major structural anomaly in the ultrasound (USG)" exhibited 31.68% sensitivity and 82.03% specificity with an odds ratio (OR) of 2.11 (95% CI: 1.37-3.27); the indication "screening test positivity" exhibited 44.55% sensitivity and 48.25% specificity [OR=0.75 (95% CI: 0.50-1.13)]; and the co-existence of "major structural anomaly in the USG" and "screening test positivity" exhibited 8.91% sensitivity and 98.24% specificity [OR=5.49 (95% CI: 2.54-11.84)]. Conclusion: Fetal chromosomal anomaly rate was observed to be 4.72%. The co-existence of a sonographic major fetal structural anomaly and serum screening test positivity was observed to maximize the risk of numerical as well as a structural chromosomal anomaly. The data from the present study which reflected screening performances of detailed USG and biochemical screening tests for the detection of fetal chromosomal anomalies may be useful for clinicians while performing detailed counseling of patients.
REFERENCES:
  1. Palomaki GE, Kloza  EM, Lambert-Messerlian GM, Haddow JE,  Neveux LM, Ehrich M,  et al. DNA sequencing of  maternal plasma to detect Down syndrome: an international  clinical vali- dation study. Genet  Med. 2011;13(11):913-20. [Crossref]  [PubMed]
  2. Cicero S, Bindra  R, Rembouskos G, Spencer K, Nicolaides KH. Integrated  ultrasound and biochemical screening for  trisomy 21 using fetal nuchal  translucency, absent fetal nasal home, free beta-hCG and  PAPP-A at 11 to  14 weeks. Prenat Diagn. 2003;23(4):306-10.  [Crossref]  [PubMed]
  3. Neagos D, Cretu R, Sfetea RC, Bohiltea LC. The importance of screening and prenatal diagnosis in the identification of the numerical chromosomal abnormalities. Maedica (Buchar). 2011;6(3):179-84.
  4. Bilen E, Yüksel  M, Köse SA, Tola  EN, Sezik M. Chorion villus sampling for karyotyping at 11-14 weeks of gestation: evaluation of 42 cases. SDÜ Sağlık Bilimleri Dergisi. 2015;6(1): 1-3.
  5. Farcaş S, Crişan CD, Andreescu N, Stoian M, Motoc AG. Structural chromosomal anomalies detected by prenatal genetic diagnosis: our experience. Rom J Morphol Embryol. 2013;54 (2):377-83. [PubMed]
  6. Wilson RD, Gagnon  A, Audibert F, Campag- nolo C, Carroll J;  Genetics Committee. Pre- natal diagnosis  procedures and techniques to obtain a diagnostic fetal  specimen or tissue: maternal and  fetal risks and benefits.  J Obstet Gynaecol Can.  2015;37(7):656-68. [Crossref]
  7. Norton ME. Follow-up of sonographically detected soft markers for fetal aneuploidy. Semin Perinatol. 2013;37(5):365-9. [Crossref]  [PubMed]
  8. Anderson CL, Brown CE. Fetal chromosomal abnormalities: antenatal screening and diag- nosis. Am Fam Physician. 2009;79(2):117-23. [PubMed]
  9. Levy B, Stosic  M. Traditional prenatal diagno- sis: past to present.  Methods Mol Biol. 2019;1885:3-22. [Crossref] [PubMed]
  10. Ekmekci E, Kurt  K, Gençdal S, Demirel  E, Kelekçi S. Prenatal invasive  testing: a 4-years single institution  experience in Turkey. Gy- necol Obstet Reprod Med. 2015;21(3):123-6.
  11. Yüce H, Çelik H, Gürateş B, Erol D, Hanay F, Elyas H. [Retrospective analysis of 356 am- niocentesis results performed for karyotype analysis]. Perinatoloji Dergisi. 2006;14(2):73- 6.
  12. Erdemoğlu M, Kale A. Prospective analysis of 183 cases who under go for amniocentesis of genetic karyotyping. Dicle Tıp Dergisi. 2007;34(3):170-5.
  13. Saatçi Ç, Bayramov  R, Basbuğ M, Güneş  MC, Dündar M. Retrospective evaluation  of results of 3617 invasive  prenatal diagnosis cases ap- plied between 1997-2015 years.  Journal of Health Sciences. 2016;25(3):120-5.
  14. Mierla D, Stoian V. Chromosomal polymor- phisms involved in reproductive failure in the Romanian population. Balkan J Med Genet. 2012;15(2):23-8. [Crossref]  [PubMed]  [PMC]
  15. Nemescu D, Bratie A, Mihaila A, Navolan D, Tanase A. First trimester combined screening for fetal aneuploidies enhanced with additional ultrasound markers: an 8-year prospective study. Ginekol Pol. 2018;89(4):205-10. [Crossref]  [PubMed]
  16. Godino L, Pompilii E, D?Anna F, Morselli-La- bate AM, Nardi E, Seri M, et al. Attitudes of women of advanced maternal age undergoing invasive prenatal diagnosis and the impact of genetic counselling. Eur J Hum Genet. 2016;24(3):331-7. [Crossref]  [PubMed]  [PMC]
  17. Marokakis S, Kasparian NA, Kennedy SE. Prenatal counselling for congenital anomalies: a systematic review. Prenat Diagn. 2016;36 (7):662-71. [Crossref]  [PubMed]
  18. Benacerraf BR. The role of the second trimester genetic sonogram in screening for fetal Down syndrome. Semin Perinatol. 2005; 29(6):386-94. [Crossref]  [PubMed]
  19. Stoll C, Dott  B, Alembik Y, Roth  MP. Evalution of routine prenatal  ultrasound examination in detecting  fetal chromosomal abnormalities in  a low risk population.  Hum Genet. 1993;91(1): 37-41. [Crossref] [PubMed]
  20. Conner SN, Longman RE, Cahill AG. The role of ultrasound in the diagnosis of fetal genetic syndromes. Best Pract Res Clin Obstet Gynaecol. 2014;28(3):417-28. [Crossref]  [PubMed]  [PMC]
  21. Zalel Y,  Zemet R, Kivilevitch  Z. The  added value of detailed  early anomaly scan  in fe- tuses with  increased nuchal translucency. Pre-nat Diagn. 2017;37(3):235-43.  [Crossref][PubMed]
  22. Benacerraf BR,  Neuberg D, Bromley  B, Frigo-  letto FD Jr.  Sonographic scoring index  for prena-tal detection of  chromosomal abnormalities. J  Ultrasound Med. 1992;11(9):449-58. [Crossref][PubMed]