scholarly journals Controversies in Pregnancy Management after Prenatal Diagnosis of a Twin Pregnancy Discordant for Trisomy 21 Diagnosed by Cell-Free Fetal DNA Testing

2017 ◽  
Vol 3 (2) ◽  
pp. 1-3
Author(s):  
Peter Schwaerzler
Author(s):  
Franco Borruto ◽  
Alain Treisser ◽  
Skander Ben Abdelkrim ◽  
Ciro Comparetto

ABSTRACT Purpose The rapid development in molecular biological technologies makes it possible to screen and to diagnosis thousands of genetic conditions, mutations and also predispositions to chronic diseases or traits, either prenatally or after birth. Clinical application of noninvasive prenatal diagnosis (NIPD) using fetal deoxyribonucleic acid (DNA) in maternal plasma has become a reality. We review the latest developments in screening and diagnosis of chromosomal diseases and a new noninvasive method of prenatal diagnosis. Materials and methods PrenaTest™ (LifeCodexx AG, Konstanz, Germany, patented and licensed by Sequenom Inc., San Diego, California, USA) is a molecular genetic test that can detect fetal trisomy 21 with a high precision level from maternal blood using new generation multiplex genome sequencing techniques. The test is based on the analysis of extracellular fetal DNA measured in the blood of pregnant women: Cell-free fetal DNA (cffDNA). Results In the case of trisomy 21, there were found 105 specific fragments of chromosome 21, 15 of fetal origin and 90 of maternal origin. The validity of PrenaTest™ has been demonstrated by many tests (427 cases), and the sensitivity was 95%, with a false negative rate of 5% and a specificity of 99.5%. Anyway, an additional ultrasound can always be performed to assess fetal morphology. Conclusion The arrival of the molecular genetic era also leads to many new ethical, social and medicolegal problems and dilemmas that obstetricians will have to face in the near future. There is an urgent need for the development of a new model for provision of genetic screening and diagnosis. How to cite this article Borruto F, Treisser A, Abdelkrim SB, Comparetto C. The End of Amniocentesis? From TriTest to PrenaTestTM. Donald School J Ultrasound Obstet Gynecol 2013;7(2):213-218.


Author(s):  
Piotr Sieroszewski ◽  
Mirosław Wielgos ◽  
Stanislaw Radowicki ◽  
Maria Sasiadek ◽  
Maciej Borowiec ◽  
...  

2012 ◽  
Vol 15 (Supplement) ◽  
pp. 17-26 ◽  
Author(s):  
Neil D. Avent ◽  
A Webb ◽  
TE Madgett ◽  
T Miran ◽  
K Sillence ◽  
...  

ABSTRACT Current invasive procedures [amniocentesis and chorionic villus sampling (CVS)] pose a risk to mother and fetus and such diagnostic procedures are available only to high risk pregnancies limiting aneuploidy detection rate. This review seeks to highlight the necessity of investing in non invasive prenatal diagnosis (NIPD) and how NIPD would improve patient safety and detection rate as well as allowing detection earlier in pregnancy. Non invasive prenatal diagnosis can take either a proteomics approach or nucleic acid-based approach; this review focuses on the latter. Since the discovery of cell free fetal DNA (cffDNA) and fetal RNA in maternal plasma, procedures have been developed for detection for monogenic traits and for some have become well established (e.g., RHD blood group status). However, NIPD of aneuploidies remains technically challenging. This review examines currently published literature evaluating techniques and approaches that have been suggested and developed for aneuploidy detection, highlighting their advantages and limitations and areas for further research.


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