Prenatal diagnosis of acrania/exencephaly/anencephaly sequence (AEAS): additional structural and genetic anomalies.

Autor: Bijok J; Department of Gynecologic Oncology and Obstetrics, Professor Witold Orlowski Public Teaching Hospital, Warsaw, Poland. julia.bijok@gmail.com.; Department of Gynecologic Oncology and Obstetrics, Centre of Postgraduate Medical Education, ul. Czerniakowska 231, 00413, Warsaw, Poland. julia.bijok@gmail.com., Dąbkowska S; Department of Gynecologic Oncology and Obstetrics, Professor Witold Orlowski Public Teaching Hospital, Warsaw, Poland., Kucińska-Chahwan A; Department of Medical Genetics, Institute of Mother and Child, Warsaw, Poland., Massalska D; Department of Gynecologic Oncology and Obstetrics, Professor Witold Orlowski Public Teaching Hospital, Warsaw, Poland.; Department of Gynecologic Oncology and Obstetrics, Centre of Postgraduate Medical Education, ul. Czerniakowska 231, 00413, Warsaw, Poland., Nowakowska B; Department of Medical Genetics, Institute of Mother and Child, Warsaw, Poland., Gawlik-Zawiślak S; Department of Genetics, Institute of Psychiatry and Neurology, Warsaw, Poland., Panek G; Department of Gynecologic Oncology and Obstetrics, Professor Witold Orlowski Public Teaching Hospital, Warsaw, Poland.; Department of Gynecologic Oncology and Obstetrics, Centre of Postgraduate Medical Education, ul. Czerniakowska 231, 00413, Warsaw, Poland., Roszkowski T; Department of Gynecologic Oncology and Obstetrics, Professor Witold Orlowski Public Teaching Hospital, Warsaw, Poland.; Department of Gynecologic Oncology and Obstetrics, Centre of Postgraduate Medical Education, ul. Czerniakowska 231, 00413, Warsaw, Poland.
Jazyk: angličtina
Zdroj: Archives of gynecology and obstetrics [Arch Gynecol Obstet] 2023 Jan; Vol. 307 (1), pp. 293-299. Date of Electronic Publication: 2022 May 12.
DOI: 10.1007/s00404-022-06584-3
Abstrakt: Objectives: To analyse additional structural and genetic anomalies in fetuses with acrania/exencephaly/anencephaly sequence (AEAS).
Methods: A retrospective analysis of 139 fetuses with AEAS diagnosed between 2006 and 2020 in a single tertiary referral ultrasound department.
Results: The median gestational age at diagnosis decreased from 15 weeks in 2006 to 13 weeks in 2020 (- 0.21 per each year; p = 0.009). In 103 fetuses, the defects were limited to the neural tube (NTD) (74.1%), in 36 fetuses (25.9%), there were additional structural non-NTD anomalies. The most common were ventral body wall defects present in 17.8% (23/139), followed by anomalies of the limbs (7.2%; 10/139), face (6.5%; 9/139) and heart (6.5%; 9/139). Genetic anomalies were diagnosed in 7 of the 74 conclusive results (9.5%; 7/74; trisomy 18, n = 5; triploidy, n = 1; duplication of Xq, n = 1). In univariate logistic regression models, male sex, limb anomalies and ventral body wall defects significantly increased the risk of genetic anomalies (OR 12.3; p = 0.024; OR 16.5; p = 0.002 and OR 10.4; p = 0.009, respectively).
Conclusions: A significant number of fetuses with AEAS have additional structural non-NTD anomalies, which are mostly consistent with limb body wall complex. Genetic abnormalities are diagnosed in almost 10% of affected fetuses and trisomy 18 is the most common aberration. Factors that significantly increased the odds of genetic anomalies in fetuses with AEAS comprise male sex, limb anomalies and ventral body wall defects.
(© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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