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Egloff M, Hervé B, Quibel T, Jaillard S, Le Bouar G, Uguen K, Saliou AH, Valduga M, Perdriolle E, Coutton C, Coston AL, Coussement A, Anselem O, Missirian C, Bretelle F, Prieur F, Fanget C, Muti C, Jacquemot MC, Beneteau C, Le Vaillant C, Vekemans M, Salomon LJ, Vialard F, Malan V. Diagnostic yield of chromosomal microarray analysis in fetuses with isolated increased nuchal translucency: a French multicenter study. Ultrasound Obstet Gynecol 2018; 52:715-721. [PMID: 29027723 DOI: 10.1002/uog.18928] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [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: 07/28/2017] [Revised: 10/04/2017] [Accepted: 10/05/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To determine the frequency and nature of copy number variants (CNVs) identified by chromosomal microarray analysis (CMA) in a large cohort of fetuses with isolated increased nuchal translucency thickness (NT) ≥ 3.5 mm. METHODS This was a retrospective, multicenter study, including 11 French hospitals, of data from the period between April 2012 and December 2015. In total, 720 fetuses were analyzed by rapid aneuploidy test and the fetuses identified as euploid underwent CMA. CNVs detected were evaluated for clinical significance and classified into five groups: pathogenic CNVs; benign CNVs; CNVs predisposing to neurodevelopmental disorders; variants of uncertain significance (VOUS); and CNVs not related to the phenotype (i.e. incidental findings). RESULTS In 121 (16.8%) fetuses, an aneuploidy involving chromosome 13, 18 or 21 was detected by rapid aneuploidy test and the remaining 599 fetuses were euploid. Among these, 53 (8.8%) had a CNV detected by CMA: 16/599 (2.7%) were considered to be pathogenic, including 11/599 (1.8%) that were cryptic (not visible by karyotyping); 7/599 (1.2%) were CNVs predisposing to neurodevelopmental disorders; and 8/599 (1.3%) were VOUS. Additionally, there was one (0.2%) CNV that was unrelated to the reason for referral diagnosis (i.e. an incidental finding) and the remaining 21 were benign CNVs, without clinical consequence. Interestingly, we identified five genomic imbalances of the 1q21.1 or 15q11.2 regions known to be associated with congenital heart defects. CONCLUSION Our study demonstrates the benefit of CMA in the etiological diagnosis of fetuses with isolated increased NT. It is worth noting that most (69%) of the detected pathogenic CNVs were cryptic. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- M Egloff
- Service d'Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, APHP, Paris, France
- Sorbonne Paris Cité, Université Paris Descartes, Paris, France
| | - B Hervé
- Unité de Cytogénétique, CHI de Poissy St Germain, Poissy, France
- EA7404-GIG, UFR des Sciences de la Santé Simone Veil, UVSQ, Montigny-le-Bretonneux, France
| | - T Quibel
- Service de Gynécologie Obstétrique, CHI de Poissy St Germain, Poissy, France
| | - S Jaillard
- Service de Cytogénétique et Biologie Cellulaire, CHU de Rennes, Rennes, France
| | - G Le Bouar
- Département de Gynécologie Obstétrique et Reproduction Humaine, CHU de Rennes, Rennes, France
| | - K Uguen
- Laboratoire de Cytogénétique, Cytologie et Biologie de la Reproduction, CHRU, Brest, France
| | - A-H Saliou
- Centre Pluridisciplinaire de Diagnostic Prénatal, CHRU, Brest, France
| | - M Valduga
- Service de Génétique, CHRU Nancy-Brabois, Nancy, France
| | - E Perdriolle
- Service d'Obstétrique, CHRU Nancy-Brabois, Nancy, France
| | - C Coutton
- Laboratoire de Génétique Chromosomique, INSERM 1209, CNRS UMR 5309, CHU Grenoble Alpes, Institut Albert Bonniot, Université Grenoble Alpes, Grenoble, France
| | - A-L Coston
- Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Hôpital Couple Enfant, Université Grenoble Alpes, CHU Grenoble Alpes, Grenoble, France
| | - A Coussement
- Laboratoire de Cytogénétique, Hôpital Cochin, APHP, Paris, France
| | - O Anselem
- Service de Gynécologie et Obstétrique de Port-Royal, Maternité Port-Royal, Groupe Hospitalier Cochin Broca Hôtel-Dieu, APHP, Paris, France
| | - C Missirian
- Département de Génétique Médicale, CHU Timone Enfants, APHM, Marseille, France
| | - F Bretelle
- Service de Gynécologie Obstétrique, CHU Nord, APHM, Marseille, France
| | - F Prieur
- Service de Génétique Clinique Chromosomique Moléculaire, CHU Saint-Etienne, Saint-Etienne, France
| | - C Fanget
- Service d'Obstétrique, CHU Saint-Etienne, Saint-Etienne, France
| | - C Muti
- Génétique Constitutionnelle, Laboratoire de Biologie, Centre Hospitalier de Versailles, Le Chesnay, France
| | - M-C Jacquemot
- Consultation de Diagnostic Prénatal, Service de Gynécologie Obstétrique, Centre Hospitalier de Versailles, Le Chesnay, France
| | - C Beneteau
- Service de Génétique Médicale, CHU Nantes, Nantes, France
| | - C Le Vaillant
- Service de Gynécologie-Obstétrique, CHU de Nantes, Nantes, France
| | - M Vekemans
- Service d'Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, APHP, Paris, France
- Sorbonne Paris Cité, Université Paris Descartes, Paris, France
| | - L J Salomon
- Sorbonne Paris Cité, Université Paris Descartes, Paris, France
- Service d'Obstétrique, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - F Vialard
- Unité de Cytogénétique, CHI de Poissy St Germain, Poissy, France
- EA7404-GIG, UFR des Sciences de la Santé Simone Veil, UVSQ, Montigny-le-Bretonneux, France
| | - V Malan
- Service d'Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, APHP, Paris, France
- Sorbonne Paris Cité, Université Paris Descartes, Paris, France
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Sergent F, Istasse F, Coston AL, Piolat C, Pons JC, Hennebicq S. [Ovarian cryopreservation: evaluation of two surgical procedures]. ACTA ACUST UNITED AC 2013; 41:681-6. [PMID: 24200987 DOI: 10.1016/j.gyobfe.2013.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To evaluate various surgical techniques for partial oophorectomy cryopreservation. To evaluate the consequences of prior exposure to cytotoxic therapy on the quality of the ovary removed. PATIENTS AND METHODS Single center retrospective observational study over 4 years of women who had ovarian cryopreservation surgery for chemotherapy or radiotherapy which were at high risk of premature ovarian failure. Several techniques have been proposed: partial oophorectomy with clamping of the vascular gonadal pedicle (indirect tissue sample) without clamping (direct tissue sample) and partial oophorectomy with an automatic stapler. Ovarian tissue was immediately prepared for cryopreservation in the operating theatre. The whole sample was divided into small slices. For each ovary, a count of small slices was made. Additionally, one slice was examined to determine the presence of primordial follicles. RESULTS Ovary was successfully removed and cryopreserved in 13 patients. Two bleeding events occurred with the direct technique, without consequences for patients. The number of fragments obtained between indirect and direct techniques was respectively 19 vs 15, P=0.18; the number of primordial follicles was 38 vs 36, P=0.87. The automatic stapler consumed too much ovarian tissue to be interesting. There were fewer fragments, 15 vs 20, P<0.05 and primordial follicles, 35 vs 40, P=0.65, after a first cycle of chemotherapy. DISCUSSION AND CONCLUSION The vascular clamping technique is safer but with no difference in the quality of the sample tissue. One cycle of chemotherapy has a pejorative impact on the quality of the sample tissue.
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Affiliation(s)
- F Sergent
- Service de gynécologie-obstétrique et médecine de la reproduction, CHU de Grenoble, C.S. 10217, 38043 Grenoble cedex 9, France; Université Joseph-Fourier, B.P. 53, 38041 Grenoble cedex 9, France.
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Coston AL, Hoffmann P, Equy V, Sergent F, Vidal C. [Fetal heart rate variability and clozapine treatment]. ACTA ACUST UNITED AC 2012; 40:549-52. [PMID: 22920232 DOI: 10.1016/j.gyobfe.2012.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2012] [Accepted: 05/16/2012] [Indexed: 10/28/2022]
Abstract
We report the 2 cases of schizophrenic patients with clozapine treatment and particularly, we underlined a reduced variability and low short-term variability, whereas biophysical ultrasound score, Dopplers and perception of fetal movements were acceptable and comfortable concerning the fetal vitality. Our aim is to show the limits of the analyzed fetal heart rate under clozapine. So, we may change our observation of fetus in chronic suffering that is usually mainly made with an informatics analysis of pregnants under clozapine.
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Affiliation(s)
- A-L Coston
- Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Couple Enfant, université Joseph-Fourrier Grenoble 1, CHU de Grenoble, BP 217, 38043 Grenoble cedex 9, France.
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