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Talantova OE, Koltsova AS, Tikhonov AV, Pendina AA, Malysheva OV, Tarasenko OA, Vashukova ES, Shabanova ES, Golubeva AV, Chiryaeva OG, Glotov AS, Bespalova ON, Efimova OA. Prenatal Detection of Trisomy 2: Considerations for Genetic Counseling and Testing. Genes (Basel) 2023; 14:genes14040913. [PMID: 37107671 PMCID: PMC10138005 DOI: 10.3390/genes14040913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/07/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
We report on the case of prenatal detection of trisomy 2 in placental biopsy and further algorithm of genetic counseling and testing. A 29-year-old woman with first-trimester biochemical markers refused chorionic villus sampling and preferred targeted non-invasive prenatal testing (NIPT), which showed low risk for aneuploidies 13, 18, 21, and X. A series of ultrasound examinations revealed increased chorion thickness at 13/14 weeks of gestation and fetal growth retardation, a hyperechoic bowel, challenging visualization of the kidneys, dolichocephaly, ventriculomegaly, increase in placental thickness, and pronounced oligohydramnios at 16/17 weeks of gestation. The patient was referred to our center for an invasive prenatal diagnosis. The patient's blood and placenta were sampled for whole-genome sequencing-based NIPT and array comparative genomic hybridization (aCGH), respectively. Both investigations revealed trisomy 2. Further prenatal genetic testing in order to confirm trisomy 2 in amniocytes and/or fetal blood was highly questionable because oligohydramnios and fetal growth retardation made amniocentesis and cordocentesis technically unfeasible. The patient opted to terminate the pregnancy. Pathological examination of the fetus revealed internal hydrocephalus, atrophy of brain structure, and craniofacial dysmorphism. Conventional cytogenetic analysis and fluorescence in situ hybridization revealed chromosome 2 mosaicism with a prevalence of trisomic clone in the placenta (83.2% vs. 16.8%) and a low frequency of trisomy 2, which did not exceed 0.6% in fetal tissues, advocating for low-level true fetal mosaicism. To conclude, in pregnancies at risk of fetal chromosomal abnormalities that refuse invasive prenatal diagnosis, whole-genome sequencing-based NIPT, but not targeted NIPT, should be considered. In prenatal cases of trisomy 2, true mosaicism should be distinguished from placental-confined mosaicism using cytogenetic analysis of amniotic fluid cells or fetal blood cells. However, if material sampling is impossible due to oligohydramnios and/or fetal growth retardation, further decisions should be based on a series of high-resolution fetal ultrasound examinations. Genetic counseling for the risk of uniparental disomy in a fetus is also required.
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Affiliation(s)
- Olga E Talantova
- D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, Mendeleevskaya Line, 3, St. Petersburg 199034, Russia
| | - Alla S Koltsova
- D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, Mendeleevskaya Line, 3, St. Petersburg 199034, Russia
| | - Andrei V Tikhonov
- D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, Mendeleevskaya Line, 3, St. Petersburg 199034, Russia
| | - Anna A Pendina
- D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, Mendeleevskaya Line, 3, St. Petersburg 199034, Russia
| | - Olga V Malysheva
- D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, Mendeleevskaya Line, 3, St. Petersburg 199034, Russia
| | - Olga A Tarasenko
- D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, Mendeleevskaya Line, 3, St. Petersburg 199034, Russia
| | - Elena S Vashukova
- D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, Mendeleevskaya Line, 3, St. Petersburg 199034, Russia
| | - Elena S Shabanova
- D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, Mendeleevskaya Line, 3, St. Petersburg 199034, Russia
| | - Arina V Golubeva
- Faculty of Biology, Department of Genetics and Biotechnology, St. Petersburg State University, Universitetskaya emb., 7/9, St. Petersburg 199034, Russia
| | - Olga G Chiryaeva
- D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, Mendeleevskaya Line, 3, St. Petersburg 199034, Russia
| | - Andrey S Glotov
- D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, Mendeleevskaya Line, 3, St. Petersburg 199034, Russia
| | - Olesya N Bespalova
- D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, Mendeleevskaya Line, 3, St. Petersburg 199034, Russia
| | - Olga A Efimova
- D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, Mendeleevskaya Line, 3, St. Petersburg 199034, Russia
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Soukkhaphone B, Lindsay C, Langlois S, Little J, Rousseau F, Reinharz D. Non-invasive prenatal testing for the prenatal screening of sex chromosome aneuploidies: A systematic review and meta-analysis of diagnostic test accuracy studies. Mol Genet Genomic Med 2021; 9:e1654. [PMID: 33755350 PMCID: PMC8172189 DOI: 10.1002/mgg3.1654] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 10/31/2020] [Accepted: 02/19/2021] [Indexed: 12/19/2022] Open
Abstract
Background There is little evidence on the performance of non‐invasive prenatal testing (NIPT) for the detection of fetal sex chromosomal imbalances. In this review, we aimed to appraise and synthesize the literature on the performance of NIPT for the prenatal detection of fetal sex chromosome aneuploidies. Methods We performed our literature search in PubMed, Embase, Cochrane Library, Web of Science, and CADTH. Study selection and data extraction were performed by two reviewers independently. There were no restrictions on the study population. Meta‐analyses were performed with “R” software. Pooled sensitivities and specificities with their 95% CI were estimated using a random‐effects model. Heterogeneity between studies was assessed by a Q test. Results Based on 11 studies in high prior risk pregnancies, including 116 affected fetuses in aggregate, Massively Parallel Shotgun Sequencing (MPSS) had a sensitivity of 93.9% (95% CI 84.1%, 97.8%) and a specificity of 99.6% (95% CI 98.7%, 99.9%) for the detection of 45,X. Based on four studies in high‐risk pregnancies, with 83 affected fetuses in aggregate, Targeted Massively Parallel Sequencing (TMPS) had a sensitivity of 83.2% (95% CI 49.6%, 96.2%) and specificity was 99.8% (95% CI 98.3%, 100%) for the detection of 45,X. In mixed‐risk pregnancies, the sensitivity of TMPS for the detection of 45,X was 90.9% (2 studies; 95% CI 70%, 97.7%) and specificity 99.9% (2 studies; 95% CI 99.4%, 100%); MPSS data were not available in such pregnancies. Based on smaller numbers of studies, and small numbers of affected fetuses in either high‐risk or mixed‐risk pregnancies (using either MPSS or TMPS), the sensitivities and specificities were equal to or greater than 76.2% for 47,XXX, 47,XXY and 47, XYY. The test failures for SCAs were 0.2% (95% CI 0%, 13.6%) for MPSS and 5.6% (95% CI 3.7%, 8.4%) for TMPS. Conclusion High‐quality studies are still desirable in order to estimate the performance of NIPT for the detection of sex chromosome imbalances.
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Affiliation(s)
| | - Carmen Lindsay
- CHU de Québec-Université Laval Research Center, Quebec City, QC, Canada
| | | | | | - Francois Rousseau
- Laval University, Quebec City, QC, Canada.,Hôpital Saint-François d'Assise, Quebec, QC, Canada
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Pendina AA, Shilenkova YV, Talantova OE, Efimova OA, Chiryaeva OG, Malysheva OV, Dudkina VS, Petrova LI, Serebryakova EA, Shabanova ES, Mekina ID, Komarova EM, Koltsova AS, Tikhonov AV, Tral TG, Tolibova GK, Osinovskaya NS, Krapivin MI, Petrovskaia-Kaminskaia AV, Korchak TS, Ivashchenko TE, Glotov OS, Romanova OV, Shikov AE, Urazov SP, Tsay VV, Eismont YA, Scherbak SG, Sagurova YM, Vashukova ES, Kozyulina PY, Dvoynova NM, Glotov AS, Baranov VS, Gzgzyan AM, Kogan IY. Reproductive History of a Woman With 8p and 18p Genetic Imbalance and Minor Phenotypic Abnormalities. Front Genet 2019; 10:1164. [PMID: 31824569 PMCID: PMC6880252 DOI: 10.3389/fgene.2019.01164] [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: 07/28/2019] [Accepted: 10/23/2019] [Indexed: 02/04/2023] Open
Abstract
We report on the phenotype and the reproductive history of an adult female patient with an unbalanced karyotype: 8p23 and 18p11.3 terminal deletions and 8p22 duplication. The indication for karyotyping of the 28-year-old patient was a structural rearrangement in her miscarriage specimen: 45,ХХ,der(8;18)t(8;18)(p23;p11.3). Unexpectedly, the patient had the same karyotype with only one normal chromosome 8, one normal chromosome 18, and a derivative chromosome, which was a product of chromosomes 8 and 18 fusion with loss of their short arm terminal regions. Fluorescence in situ hybridization revealed that derivative chromosome was a pseudodicentric with an active centromere of chromosome 8. Array comparative genomic hybridization confirmed 8p and 18p terminal deletions and additionally revealed 8p22 duplication with a total of 43 OMIM annotated genes being affected by the rearrangement. The patient had minor facial and cranial dysmorphia and no pronounced physical or mental abnormalities. She was socially normal, had higher education and had been married since the age of 26 years. Considering genetic counseling, the patient had decided to conceive the next pregnancy through in vitro fertilization (IVF) with preimplantation genetic testing for structural chromosomal aberrations (PGT-SR). She underwent four IVF/PGT-SR cycles with a total of 25 oocytes obtained and a total of 10 embryos analyzed. Only one embryo was balanced regarding chromosomes 8 and 18, while the others were unbalanced and demonstrated different combinations of the normal chromosomes 8 and 18 and the derivative chromosome. The balanced embryo was transferred, but the pregnancy was not registered. After four unsuccessful IVF/PGT-SR cycles, the patient conceived naturally. Non-invasive prenatal testing showed additional chromosome 18. The prenatal cytogenetic analysis of chorionic villi revealed an abnormal karyotype: 46,ХХ,der(8;18)t(8;18)(p23;p11.3)mat,+18. The pregnancy was terminated for medical reasons. The patient has a strong intention to conceive a karyotypically normal fetus. However, genetic counseling regarding this issue is highly challenging. Taking into account a very low chance of balanced gametes, emotional stress caused by numerous unsuccessful attempts to conceive a balanced embryo and increasing age of the patient, an IVF cycle with a donor oocyte should probably be considered.
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Affiliation(s)
- Anna A. Pendina
- D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
| | - Yulia V. Shilenkova
- D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
| | - Olga E. Talantova
- D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
| | - Olga A. Efimova
- D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
| | - Olga G. Chiryaeva
- D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
| | - Olga V. Malysheva
- D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
| | - Vera S. Dudkina
- D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
| | - Lubov' I. Petrova
- D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
| | - Elena A. Serebryakova
- D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
| | - Elena S. Shabanova
- D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
| | - Irina D. Mekina
- D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
| | - Evgeniia M. Komarova
- D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
| | - Alla S. Koltsova
- D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
- St. Petersburg State University, St. Petersburg, Russia
| | - Andrei V. Tikhonov
- D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
| | - Tatyana G. Tral
- D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
| | - Gulrukhsor Kh. Tolibova
- D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
| | - Natalia S. Osinovskaya
- D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
| | - Mikhail I. Krapivin
- D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
- St. Petersburg State University, St. Petersburg, Russia
| | - Anastasiia V. Petrovskaia-Kaminskaia
- D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
- St. Petersburg State University, St. Petersburg, Russia
| | - Taisia S. Korchak
- St. Petersburg State Pediatric Medical University, St. Petersburg, Russia
| | - Tatyana E. Ivashchenko
- D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
| | - Oleg S. Glotov
- D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
- City Hospital №40, St. Petersburg, Russia
| | | | | | | | | | | | - Sergei G. Scherbak
- St. Petersburg State University, St. Petersburg, Russia
- City Hospital №40, St. Petersburg, Russia
| | | | - Elena S. Vashukova
- D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
| | - Polina Y. Kozyulina
- D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
| | | | - Andrey S. Glotov
- D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
- St. Petersburg State University, St. Petersburg, Russia
| | - Vladislav S. Baranov
- D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
- St. Petersburg State University, St. Petersburg, Russia
| | - Alexander M. Gzgzyan
- D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
| | - Igor Yu. Kogan
- D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
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