Abstract

BackgroundThe aims of this study were to evaluate the clinical utility of multiplex ligation-dependent probe amplification (MLPA) and array comparative genomic hybridization (aCGH) analyses on prenatal cases and to review prenatal ultrasound findings of cytogenomic syndromes.ResultsOf the 54 prenatal cases analyzed, cytogenomic abnormalities were characterized in 14 cases. In four fetuses with abnormal ultrasound findings, a 40.701 Mb duplication of 8q22.3-q24.3 and a 23.839 Mb deletion of 7q33-q36.3 derived from a paternal balanced translocation, a de novo 13.062 Mb deletion of 11q24.1-q25 for Jacobsen syndrome, a de novo 19.971 Mb deletion of 7q11.23-q21.3 for type 1 split-hand/foot malformation (SHFM1), and a de novo 28.909 Mb duplication of 3q21.1-q25.1 were detected. A 699.8 Kb deletion at 5p15.33 for Cri du Chat syndrome was confirmed in a fetus with abnormal MLPA result. A fetus with abnormal maternal screening was detected with a de novo distal 1.747 Mb duplication at 2q37.1-q37.2 and a 6.664 Mb deletion at 2q37.2-q37.3. Of the eight cases referred by history of spontaneous abortions, derivative chromosomes 11 from paternal carriers of a balanced 8q/11q and a 10q/11q translocation were noted in two cases, simple aneuploids of trisomy 2 and trisomy 21 were seen in three cases, and compound aneuploids of two or three chromosomes were found in three cases. Post-test genetic counseling was performed with detailed genomic information and well characterized postnatal syndromic features.ConclusionsThese results demonstrated that coupling MLPA screening and aCGH analysis are a cost-effective approach to detect cytogenomic abnormalities in a prenatal setting. The aCGH analysis provided not only genomic maps of breakpoints and gene content of imbalanced regions but also better inference of related phenotypes for genetic counseling. Prenatal ultrasound findings reported in the literature for Jacobsen syndrome, SHFM and Cri du Chat syndrome were summarized for use as diagnostic references.

Highlights

  • The aims of this study were to evaluate the clinical utility of multiplex ligation-dependent probe amplification (MLPA) and array comparative genomic hybridization analyses on prenatal cases and to review prenatal ultrasound findings of cytogenomic syndromes

  • We reviewed prenatal ultrasound findings reported in literature for Jacobsen syndrome, SHFM1 and Cri du Chat syndrome

  • The patient history, detailed prenatal clinical findings and cytogenomic results for each case are described as follows: Case 1 Amniocentesis was performed because of multiple malformations detected at 12 weeks of gestation

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Summary

Introduction

The aims of this study were to evaluate the clinical utility of multiplex ligation-dependent probe amplification (MLPA) and array comparative genomic hybridization (aCGH) analyses on prenatal cases and to review prenatal ultrasound findings of cytogenomic syndromes. Multiplex ligation-dependent probe amplification (MLPA) was validated as a rapid, cost-effective and multiallelic approach for prenatal screening of common aneuploids, recurrent genomic disorders and subtelomeric imbalances [8-11]. For pediatric patients with intellectual and developmental disabilities, genome-wide array comparative genomic hybridization (aCGH) using synthesized oligonucleotides has been validated and recommended as first tier genetic testing [12-14] Extended application of this aCGH analysis on prenatal diagnosis has been effective in defining gene content of chromosomal imbalances and in detecting genomic disorders and cryptic aberrations [15-17]. We reviewed prenatal ultrasound findings reported in literature for Jacobsen syndrome, SHFM1 and Cri du Chat syndrome

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