Non-Invasive Prenatal Genetic Screening to Detect Trisomies In Singleton and Twin Pregnancies

A. Razdan, R. Arora, Gauri G Agarwal, Vandana Sharma, J. Kandpal, N. Singh, Malobi Nandi
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Abstract

Background Screening for fetal anomalies is one of the most critical parts of prenatal testing to reduce the burden of chromosomal aberrations and improve clinical outcomes in pregnancy. The available literature suggests that India carries a strong economic, emotional, and health care burden of new-born genetic diseases. Material and Methods: We present a single-center retrospective study of 200 singletons and 6 dichorionic diamniotic twin gestations screened for chromosomal abnormalities and trisomies using NIPT.  The patients were presented with a gestation period of 10-12 (plus a few days) weeks, clinically confirmed with singleton or diamniotic dizygotic twins, who underwent NIPT between the years 2021-2022 (mid) at our center. All the patients underwent sonographic examination and biochemical investigations with regular follow-up and genetic counseling. The clinical history and family history of the presence of any genetic disease or any other disease were previously taken by the clinician in all cases. The main clinical indications were increased risk of trisomies found in markers test, advanced maternal age, or presented with some mild complications in pregnancy. Results; Out of the total (206) pregnancies, only 2 singleton cases were found at high risk in NIPT screen, prospectively followed up, and showed normal twins in six cases of twin pregnancy growing successfully. The high-risk cases were genetically counselled and further tests using amniotic or chorionic villi samples were recommended by the clinician with regular clinical follow-up. Conclusion: This retrospective study clearly indicates that non-invasive prenatal testing in pregnancy is a safe and effective screening test to rule out certain chromosomal abnormalities and to omit the need of further invasive tests among low-risk cases.
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无创产前基因筛查检测单胎和双胎三体
背景胎儿异常筛查是产前检查中最关键的部分之一,可以减少染色体畸变的负担,改善妊娠的临床结果。现有文献表明,印度在新生儿遗传疾病方面具有很强的经济、情感和医疗负担。材料和方法:我们提出了一项单中心回顾性研究,对200个单胎和6个双绒毛膜双羊膜双胞胎妊娠进行了NIPT筛查染色体异常和三体。患者的妊娠期为10-12周(加上几天),临床证实为单胎或双胎异卵双胞胎,于2021-2022年(中期)在我中心接受NIPT。所有患者均行超声检查和生化检查,并定期随访和遗传咨询。所有病例的临床病史和家族史均由临床医生事先记录。结果:206例妊娠中,仅有2例单胎在NIPT筛查中发现高危,经前瞻性随访,6例双胎妊娠发育成功,其中6例为正常双胎。对高危病例进行遗传咨询,临床医生建议使用羊膜或绒毛膜样本进行进一步检测,并定期进行临床随访。结论:本回顾性研究清楚地表明,妊娠期无创产前检查是一种安全有效的筛查试验,可排除某些染色体异常,并在低危病例中省略进一步的有创检查。
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