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1.
Rev. chil. obstet. ginecol. (En línea) ; 88(1): 16-24, 2023. ilus, graf, tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1431752

ABSTRACT

Introducción: Las cardiopatías congénitas son las anomalías más frecuentes y la principal causa de muerte infantil y neonatal. El diagnóstico prenatal mejora el resultado perinatal determinando el lugar de nacimiento y el nivel de cuidado neonata. La telemedicina mediante videoconferencia en tiempo real permite mejorar la precisión diagnóstica y planificar el nacimiento. Objetivo: Determinar el diagnóstico y manejo perinatal de fetos con sospecha de cardiopatía congénitas, evaluadas a través de telemedicina en tiempo real atendidas en CERPO en el periodo 2017-2022. Material y métodos: Estudio retrospectivo de las evaluaciones mediante telemedicina en tiempo real realizadas en CERPO entre los años 2017 a 2022. Se revisó el resultado perinatal y se compararon los diagnósticos pre y postnatales, extraídos de la base de datos CERPO y Unidad de Neonatología del Hospital Luis Tisné Brousse. Resultados: La correlación del diagnóstico de cardiopatía congénita mediante telemedicina es de un 81,8% y de 89,8% con el diagnostico posnatal. Conclusiones: La evaluación por medio de telemedicina permite mejorar la precisión diagnostica de la cardiopatía congénita en áreas con escaso acceso a operadores experimentados en evaluación cardiaca fetal. Esto minimiza el impacto económico y social asociado al manejo perinatal de un feto con cardiopatía congénita en nuestro país.


Introduction: Congenital heart disease is the most common anomaly and the leading cause of infant and neonatal death. Prenatal diagnosis improves perinatal outcomes by choosing the right place of birth and level of neonatal care. Telemedicine by videoconferencing in real-time allows for improved diagnostic accuracy and birth planning. Objective: To determine the diagnosis and perinatal management of fetuses with suspected congenital heart disease, evaluated by telemedicine at CERPO in the period 2017-2022. Material and Methods: Retrospective study of evaluations via real-time videoconferencing performed at CERPO between 2017-2022. The perinatal outcome was reviewed, and pre and postnatal diagnoses were compared. The data was extracted from the CERPO database and the Neonatology Unit of the Luis Tisné Brousse Hospital. Results: The correlation of congenital heart disease diagnosis by telemedicine was 81.8% and 89.8% with postnatal diagnosis. Conclusions: Telemedicine assessment improves the diagnostic accuracy of congenital heart disease in areas with poor access to an experienced fetal cardiac specialist. This minimizes the economic and social impact associated with our countrys perinatal management of a fetus with congenital heart disease.


Subject(s)
Humans , Prenatal Diagnosis/methods , Telemedicine/methods , Heart Defects, Congenital/diagnosis , Congenital Abnormalities/diagnosis , Echocardiography , Retrospective Studies , Videoconferencing , Heart Defects, Congenital/therapy
2.
Rev. chil. obstet. ginecol. (En línea) ; 87(2): 97-103, abr. 2022. ilus, tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1388725

ABSTRACT

OBJETIVO: Analizar la implementación de la prueba rápida de reacción en cadena de la polimerasa cuantitativa y fluorescente (QF-PCR) para la detección de aneuploidías. MÉTODO: Se incluyeron todas las pacientes que se realizaron una QF-PCR entre septiembre de 2017 y mayo de 2021. En todos los casos se consignaron los datos clínicos, ecográficos y de laboratorio, y se efectuó un seguimiento de quienes se realizaron además cariograma y su resultado fue normal. RESULTADOS: Se realizaron 213 procedimientos invasivos genéticos prenatales, siendo 72 para detección rápida de aneuploidía mediante QF-PCR. El promedio de edad de las madres con QF-PCR fue de 37 años y 48 pacientes (67%) tenían menos de 15 semanas de gestación. La QF-PCR demostró aneuploidía de los cromosomas 18, 13 y de triploidía en 21 de 49 casos informados como anormales. De los 22 casos sin sugerencia de alteración, 17 accedieron a proseguir el estudio con cariotipo, que resultó anormal en 6 casos. Hubo 4 casos de discordancia entre la QF-PCR y el cariotipo, que pudo afectar el manejo clínico de la gestación. En 25/72 casos (34,7%) la aneuploidía era letal. CONCLUSIONES: Considerando la necesidad de tener un diagnóstico rápido, pero también completo y que permita un consejo genético apropiado, debería integrarse la QF-PCR a un protocolo de diagnóstico que considere variables clínicas y ecográficas.


OBJECTIVE: To analyze the performance of QF-PCR test for the detection of aneuploidies. METHOD: All patients who underwent QF-PCR from September 2017 to May 2021, were included. Clinical, ultrasound and laboratory data were recorded in all cases, as well as follow-up of the cases, including those performing karyotype and the result was normal. RESULTS: 213 prenatal genetic invasive procedures were performed in the study period, 72 for rapid detection of aneuploidy by QF-PCR. 48 patients (67%) were less than 15 weeks at the time of ultrasound diagnosis. The QF-PCR test demonstrated aneuploidy of chromosomes 18, 13, and triploidy in 21/49 cases reported as abnormal. Of the cases without suggestion of alteration (22), 17 agreed to continue the study with a karyotype, which was abnormal in 6 cases. There were 4 cases of discrepancy between QF-PCR and karyotype, which could affect the clinical management of pregnancy. 25/72 cases (34. 7%) corresponded to lethal aneuploidy. CONCLUSIONS: Our results justify the use of QF-PCR. Considering the need to have a rapid diagnosis, but also complete and that allows appropriate genetic counseling, it is that QF-PCR should be integrated into a protocol that considers clinical and ultrasound variables.


Subject(s)
Humans , Female , Pregnancy , Adult , Prenatal Diagnosis/methods , Polymerase Chain Reaction/methods , Aneuploidy , Chromosome Aberrations , Cytogenetic Analysis , Genetic Counseling
3.
Article in Chinese | WPRIM | ID: wpr-928439

ABSTRACT

OBJECTIVE@#To analyze the genomic variation characteristics of fetal with abnormal serological screening, and to further explore the value of copy number variation (CNV) detection technology in prenatal diagnosis of fetal with abnormal serological screening.@*METHODS@#7617 singleton pregnant women who underwent amniocentesis for prenatal diagnosis solely due to abnormal Down's serological screening were selected. According to the results of serological screening, the patients were divided into high risk group, borderline risk group and single abnormal multiple of median (MOM) group. CMA and CNV-Seq were used to detect the copy number variation of amniotic fluid cell genomic DNA and combined with amniotic fluid cell karyotype analysis for prenatal diagnosis. Outpatient revisit combined with telephone inquiry was used for postnatal follow-up.@*RESULTS@#Among 7617 amniotic fluid samples, aneuploidy was detected in 138cases (1.81%) by CMA and CNV-Seq, 9 cases of aneuploid chimerism were detected by amniotic fluid cell karyotype analysis, and 203 cases of fetus carrying pathogenic and likely pathogenic CNV (P/LP CNV) were detected, the variant of uncertain significance (VUS) was detected in 437 cases (5.7%), the overall abnormal detection rate was 10.33%. The detection rate of aneuploidy by CMA and CNV-Seq in three group were 123 cases (2.9%), 13 cases (1.3%) and 2 cases (0.4%), respectively,and showing no significant difference (χ 2=7.469, P=0.024). The detection rate of pathogenic and likely pathogenic CNV in three group were 163cases (2.6%); 24 cases (2.6%) and 16 cases (3.3%), respectively, and showing no significant difference (χ 2=0.764, P=0.682). The CMA reported 2.9% (108/3729)P/LP CNV, and CNV-seq reported 2.4% (95/3888)P/LP CNV, both tests showed similar detective capabilities (χ 2=1.504, P=0.22).The most popular P/LP CNV in this cohort were Xp22.31 microdeletion, 16p13.11 microduplication /microdeletion, 22q11.21 microduplication /microdeletion. In fetuses with P/LP CNV CNV, 59 fetuses were terminated pregnancy, and 32 of 112 fetuses born had abnormal clinical manifestations. Non-medically necessary termination of pregnancy occurred in 11 fetuses carrying VUS CNV, 322 fetuses carrying VUS CNV were born, 4 of them presented abnormal clinical manifestations.@*CONCLUSION@#Compared with the traditional chromosome karyotype, CMA and CNV-Seq can improve the detection rate of pathogenic and likely pathogenic CNV. CMA and CNV-seq can be used for first tier diagnosis of pregnant women in the general population with abnormal Down's serological screening.


Subject(s)
Female , Humans , Pregnancy , Amniotic Fluid , Aneuploidy , Chromosome Aberrations , DNA Copy Number Variations , Genomics , Pregnancy Trimester, Second , Pregnant Women , Prenatal Diagnosis/methods , Technology
4.
Article in Chinese | WPRIM | ID: wpr-935293

ABSTRACT

To study the parental origin and cell stage of nondisjunction in sex chromosome aneuploidies. Retrospectiving and analyzing the results of 385 cases of SCA confirmed by QF-PCR and karyotype analysis in the prenatal diagnosis center of Guangzhou Women and Children Medical Center from January 2015 to December 2020. The types of samples and prenatal diagnosis indications were analyzed. The parental origin and cell stage of nondisjunction in sex chromosome aneuploidies analyzed by comparing the short tandem repeat (STR) peak patterns of samples from fetuses and maternal peripheral blood. The results show that (1) There were 324 cases of nonmosaic SCA, 113 cases (113/324, 34.9%) were 45, XO, 118 cases (118/324, 36.4%) were 47, XXY, 48 cases (48/324, 14.8%) were 47, XXX and 45 cases (45/324, 13.9%) were 47, XYY. 68 (45/324, 60.2%) cases of 45, X were detected in villus samples. The other SCA cases were mainly detected in amniotic fluid samples. There were 61 mosaic SCA samples, 58(58/61, 95.1%) of mosaic SCA samples were mosaic 45, X. (2) The top two indications of 45, X cases are increased nuchal translucency(53/113, 46.9%) and fetal cystic hygroma (41/113, 36.3%), while the most common indication of other types of SCA was high risk of NIPT(170/272, 62.5%). (3) Among 45, X cases, there were 88 cases (88/113, 77.9%) inherit their single X chromosome from their mother and 25 cases (25/119, 22.1%) from their father. In 47, XXY samples, 47 cases (47/118, 39.8%) of chromosome nondisjunction occurred in meiosis stage Ⅰ of oocytes, 51 cases (51/118, 43.2%) occurred in meiosis stage Ⅰ of spermatocytes, and 20 cases (20/118, 16.9%) occurred in meiosis stage Ⅱ of oocytes. Among 47, XXX samples, 29 cases (29/48, 60.4%) of X chromosome nondisjunction occurred in meiosis stage Ⅰof oocytes, 15 cases (15/48, 31.3%) occurred in meiosis stage Ⅱ of oocytes, and 4 cases (4/48, 8.3%) occurred in meiosis stage Ⅱ of spermatocytes. In summary , the cases of 45, X were mainly diagnosed by villous samples for abnormal ultrasound findings. The other cases of SCA were mainly diagnosed by amniocentesis samples for abnormal NIPT results. Different types of SCA, the origin and occurrence period of sex chromosome nondisjunction were different.


Subject(s)
Female , Humans , Male , Pregnancy , Aneuploidy , Karyotyping , Prenatal Diagnosis/methods , Sex Chromosome Aberrations , Sex Chromosomes/genetics
5.
Rev. medica electron ; 42(5): 2408-2415, sept.-oct. 2020. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1144744

ABSTRACT

RESUMEN Las genodermatosis ictiosiformes constituyen un grupo heterogéneo de trastornos de la cornificación caracterizados por hiperqueratosis y descamación de la piel. La ictiosis arlequín es la forma más grave y agresiva de las ictiosis congénitas, presenta una baja prevalencia (1/300 000 nacimientos) con expresividad clínica variable, una evolución desfavorable y pronóstico reservado. Se presenta con un patrón autosómico recesivo y su diagnóstico prenatal es aún difícil. Se presentó el caso de un recién nacido masculino pretérmino de 34 semanas gestacionales, sin historia familiar de trastornos de piel, con un cuadro característico de ictiosis arlequín, quien falleció a los 11 días de vida. Se realizó la caracterización clínica y anatomopatológica de la enfermedad y se ofrece una revisión sobre esta rara entidad (AU).


ABSTRACT Ichthyosiform genodermatoses are a heterogeneous group of cornification disorders characterized by hyperkeratosis and skin flaking. Harlequin ichthyosis is the most aggressive and serious form of congenital ichthyoses, presenting a low prevalence (1/300 000 births), with variable clinical expressivity, an unfavorable evolution and reserved prognosis. It appears with an autosomal recessive pattern and its prenatal diagnosis is still difficult. The authors present the case of a male preterm newborn, of 34 gestational weeks, without family history of skin disorders, and clinical characteristics of Harlequin ichthyosis, who died at the 11 day of birth. The disease clinical and anatomopathologic characterization was carried out and a review of this rare entity is made (AU).


Subject(s)
Humans , Male , Infant, Newborn , Ichthyosis, Lamellar/diagnosis , Genetic Diseases, Inborn/diagnosis , Prenatal Diagnosis/methods , Ichthyosis, Lamellar/mortality , Ichthyosis, Lamellar/therapy , Ichthyosis, Lamellar/epidemiology , Hyperkeratosis, Epidermolytic/diagnosis , Critical Pathways/standards
6.
Rev. chil. obstet. ginecol. (En línea) ; 85(4): 335-342, ago. 2020. tab
Article in Spanish | LILACS | ID: biblio-1138629

ABSTRACT

INTRODUCCIÓN: En Chile, la norma técnica de la Ley N° 21.030 de 2017 considera tres aneuploidías como letales; las trisomías 9, 13 y 18, cuyo diagnóstico se confirma con un cariograma. No existe a la fecha registro nacional de frecuencia prenatal de estas patologías. OBJETIVO: Determinar la frecuencia de trisomías 9, 13 y 18 en los estudios citogenéticos prenatales en muestras de células obtenidas con amniocentesis y cordocentesis, procesados en el Laboratorio de Citogenética del Hospital Clínico Universidad de Chile. MATERIALES Y MÉTODOS: Estudio descriptivo y retrospectivo de los resultados de cariograma de líquido amniótico (LA) y sangre fetal (SF), procesados desde enero de 2000 a diciembre de 2017. RESULTADOS: Se incluyeron 2.305 muestras (402 de SF y 1.903 de LA), de ellas 442 (19%) fueron trisomías letales (TL), dentro de ellas fueron TL libres 416 (95%), TL estructurales 15 (2,7%) y mosaicos 11 (2,3%). La trisomía 18 fue en ambos tipos de muestra la más frecuente (73,5%), seguida de trisomía 13 (24,2%) y trisomía 9 (2,3%). Se desglosan resultados conforme al tipo de TL, muestra, motivo de derivación, edad materna y edad gestacional. CONCLUSIONES: El cariograma confirma el diagnóstico de aneuploidías y aporta datos relevantes para el consejo genético. La cromosomopatía letal más frecuente fue la trisomía 18. Se observó que uno de cada cinco cariogramas referidos por anomalías congénitas y/o marcadores de aneuploidía revelaban una TL.


INTRODUCTION: In Chile, the technical standard of Law No. 21,030 of 2017 considers three aneuploidies as lethal; trisomies 9, 13 and 18, whose diagnosis is confirmed with a Karyotype. To date there is not a national registry of prenatal frequency of these pathologies. OBJECTIVE: To determine the frequency of trisomies 9, 13 and 18 in prenatal cytogenetic studies in samples of cells obtained with amniocentesis and cordocentesis, processed in the Cytogenetics Laboratory of the Universidad de Chile Clinical Hospital. MATERIALS AND METHODS: Descriptive and retrospective study of the results of karyotypes of amniotic fluid (LA) and fetal blood (SF) processed from January 2000 to December 2017. Results: 2,305 samples (402 of SF and 1,903 of LA) were included, of which 438 (19%) were lethal trisomies (TL), corresponding to free TL 416 (95%), structural TL 12 (2,7%) and mosaics 10 (2.3%). Trisomy 18 was the most frequent in both types of sample (73,5 %), followed by trisomy 13 (24,2%) and trisomy 9 (2.3%). RESULTS are shown according to the type of TL, sample, reason for referral, maternal age and gestational age. CONCLUSIONS: The karyotype confirms the diagnosis of aneuploidies and provides relevant data for genetic counseling. The most frequent lethal chromosomopathy was trisomy 18. It was observed that one in five karyotypes referred for congenital anomalies and / or aneuploidy markers revealed a TL.


Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Middle Aged , Young Adult , Prenatal Diagnosis/methods , Cytogenetic Analysis , Trisomy 13 Syndrome/diagnosis , Trisomy 18 Syndrome/diagnosis , Prenatal Diagnosis/statistics & numerical data , Trisomy , Epidemiology, Descriptive , Retrospective Studies , Fetal Blood , Karyotype , Trisomy 13 Syndrome/genetics , Trisomy 13 Syndrome/epidemiology , Trisomy 18 Syndrome/genetics , Trisomy 18 Syndrome/epidemiology , Amniocentesis , Amniotic Fluid , Aneuploidy
7.
Rev. cuba. pediatr ; 92(2): e822, abr.-jun. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1126743

ABSTRACT

Introducción: El diagnóstico prenatal mediante la hibridación fluorescente in situ disminuye el tiempo de diagnóstico al no ser necesario el cultivo celular. Objetivo: Describir las características y experiencias del diagnóstico prenatal por hibridación fluorescente in situ en Cuba. Método: En amniocitos in situ se aplicaron sondas CEP y LSI para la detección de aneuploidías de los cromosomas 21,18,13, X y Y y sondas LSI para la detección de deleciones asociadas a síndromes de microdeleción. Resultados: Se remitieron al Centro Nacional de Genética Médica 629 casos de alto riesgo genético. Prevaleció la indicación de alteraciones fetales detectadas por ecografía. En 612 (97 por ciento) casos se obtuvo un diagnóstico satisfactorio, entre ellos, 50 (8,1 por ciento) casos positivos, con predominio del síndrome Down en 26 casos. Se corroboraron por citogenética convencional 312 casos con 98 por ciento de concordancia con los resultados obtenidos por hibridación fluorescente in situ. Se utilizó el líquido amniótico refrigerado para corroborar casos de diagnóstico dudoso obtenido por citogenética y se detectaron 3 fetos con mosaicos cromosómicos, el origen de un cromosoma marcador y la definición del sexo fetal en un caso. Conclusiones: Con la tecnología por hibridación fluorescente in situ el diagnóstico prenatal logra una segura opción de análisis en aquellos casos de embarazos de alto riesgo genético. Debido a limitaciones tecnológicas, la prueba por hibridación fluorescente in situ en células amnióticas en interfase, se ha adaptado a nuestras condiciones, para lograr siempre un diagnóstico seguro con el menor perjuicio posible a la embarazada, el feto y su familia(AU)


Introduction: Prenatal diagnosis by fluorescent in situ hybridization decreases the time of diagnosis not being necessary the cell culture. Objective: To describe the characteristics and experiences of prenatal diagnosis by fluorescent in situ hybridization in Cuba. Method: In in situ amniocytes CEP catheters were applied and LSI for the detection of aneuploidies of the 21,18,13, X and Y chromosomes, and LSI catheters for the detection of deletions associated with microdeletion syndromes. Results: 629 cases of high genetic risk were referred to the National Center of Medical Genetics. There was a prevalence of the indication of fetal abnormalities detected by ultrasound. In 612 (97 percent) cases the diagnosis was achieved in a satisfactory form, among them 50 (8.1 percent) positive cases, with predominance of Down syndrome in 26 cases. There were corroborated 312 cases by conventional cytogenetics with 98 percent of agreement with the results obtained by fluorescent in situ hybridization. It was used the cooled amniotic fluid to corroborate cases of uncertain diagnosis obtained by cytogenetics and there were detected 3 fetuses with chromosomal mosaics, the origin of a marker chromosome and the definition of fetal sex in one case. Conclusions: With the technology by fluorescent in situ hybridization, the prenatal diagnosis achieved a safe analysis option in cases of genetic high-risk pregnancies. Due to technological limitations, the test by fluorescent in situ hybridization in amniotic cells in interphase has adapted to the conditions in order to always achieve a safe diagnosis with the less possible damage to the pregnant women, the fetus and its family(AU)


Subject(s)
Humans , Female , Pregnancy , Prenatal Diagnosis/methods , In Situ Hybridization, Fluorescence/methods , Epidemiology, Descriptive , Retrospective Studies
9.
Rev. cuba. obstet. ginecol ; 45(4): e440, oct.-dic. 2019. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1126709

ABSTRACT

RESUMEN Introducción: La pesquisa prenatal de anomalías cromosómicas, mediante el uso de marcadores epidemiológicos y ecográficos del primer trimestre permite identificar gestantes con riesgo incrementado de síndrome de Down. Objetivos: Analizar la edad materna, la translucencia nucal, el ductus venoso y el hueso nasal, durante el cribaje del primer trimestre, en las gestantes que se realizaron diagnóstico prenatal citogenético, con el fin de evaluar la efectividad del mismo en la detección temprana del síndrome Down y su utilidad para la reducción del número de pruebas invasivas. Métodos: Se realizó un estudio descriptivo retrospectivo de corte transversal y se analiza una muestra de 3439 gestantes a las que se realizó el estudio citogenético indicado en el Centro Provincial de Genética Médica de La Habana, en el período comprendido entre el 3 de enero de 2006 y el 30 de diciembre de 2008. Resultados: La edad materna avanzada mostró una sensibilidad de un 87 por ciento del test y una tasa de falsos positivos de 99 por ciento. La translucencia nucal se comportó con una sensibilidad de 10 por ciento. El hueso nasal no mostró asociación con los cariotipos positivos para síndrome de Down. Al no realizarse sistemáticamente la presencia del ductus venoso, no se pudo establecer una asociación estadística. La estimación de riesgo de síndrome de Down basada únicamente en la edad materna avanzada determina una alta tasa de falsos positivos. Por lo que este marcador, unido a la evaluación de los marcadores ecográficos del primer trimestre para recalcular el riesgo individual, puede aumentar la efectividad en el diagnóstico y disminuir el número de pruebas invasivas. Conclusiones: La estimación de riesgo de síndrome de Down basada únicamente en la edad materna avanzada determina una alta tasa de falsos positivos. Por lo que este marcador, unido a la evaluación de los marcadores ecográficos del primer trimestre para recalcular el riesgo individual, puede aumentar la efectividad en el diagnóstico y disminuir el número de pruebas invasivas(AU)


ABSTRACT Introduction: The prenatal investigation of chromosomal abnormalities through the use of epidemiological and echographic markers on the first trimester, allows to identify pregnant women with an increased risk of Down syndrome. Objectives: To analyze maternal age, nuchal translucency, venous ductus and nasal bone, during the first trimester screening, in pregnant women who underwent prenatal cytogenetic diagnosis, in order to evaluate effectiveness in early detection of Down syndrome and the value for reducing the number of invasive tests. Methods: A descriptive retrospective cross-sectional study was carried out and a sample of 3439 pregnant women was studied. The cytogenetic study ordered at Havana Provincial Center for Medical Genetics was carried out from January 3, 2006 to December 30, 2008. Results: Advanced maternal age showed 87 percent sensitivity and 99 percent of false positive rate. Nuchal translucency accounted 10 percent of sensitivity. The nasal bone showed no association with positive karyotypes for Down syndrome. A statistical association of the venous ductus presence could not be established since the search was not systematically. Conclusions: The estimation of Down syndrome risk based solely on advanced maternal age determines high false positive rate. Therefore, this marker, together with the evaluation of the first trimester ultrasound markers for recalculating the individual risk, can increase the diagnostic effectiveness and decrease the number of invasive tests(AU)


Subject(s)
Humans , Female , Pregnancy , Pregnancy Trimester, First , Prenatal Diagnosis/methods , Mass Screening/adverse effects , Down Syndrome/diagnosis , Nuchal Translucency Measurement/methods , Epidemiology, Descriptive , Cross-Sectional Studies , Retrospective Studies , Cytogenetics/methods
10.
Femina ; 47(9): 569-572, 20190930.
Article in Portuguese | LILACS | ID: biblio-1046548

ABSTRACT

O incremento do arsenal diagnóstico do pré-natal, por meio de exames de ultrassom, com tecnologias de imagens cada vez mais perfeitas, proporciona o estudo detalhado da anatomia fetal. A mortalidade infantil está diretamente relacionada com as malformações congênitas fetais, especialmente com as alterações anatômicas do coração. Aproximadamente 90% das gestantes não apresentam nenhum fator de risco para malformações cardíacas congênitas (MCCs), portanto o rastreamento pré-natal deve ser realizado em todas as gestações, conforme sugestão da primeira Diretriz Brasileira de Cardiologia Fetal. A revisão bibliográfica da literatura sugere que o diagnóstico pré-natal das MCCs permite intervenções fetais durante o pré-natal e adequado planejamento do parto. Essas ações interferem na morbiletalidade perinatal e no prognóstico dos fetos portadores de cardiopatias, além de auxiliarem a equacionar as vagas nos hospitais de referência e estimarem os gastos na saúde pública e privada.(AU)


The improvement of the ultrasound scan used in the prenatal evaluations provides better images data for the study of the fetal heart. Congenital heart malformations are one of the most leading causes of infant death in the world. Ninety percent of pregnant women do not present any risk factors for Congenital Heart Malformations, so prenatal screening should be performed in all pregnancies, as suggested by the first Brazilian Guideline on Fetal Cardiology. The literature review propose that prenatal diagnosis of congenital heart malformations supports fetal care satisfactory delivery planning and interventions during prenatal. These kindness influences the prognosis of the cardiopathies, perinatal morbidity and mortality and help to reorganize hospital admission and public health care.(AU)


Subject(s)
Humans , Female , Pregnancy , Prenatal Diagnosis/methods , Fetal Heart/abnormalities , Fetal Heart/embryology , Fetal Heart/physiopathology , Heart Defects, Congenital/diagnostic imaging , Echocardiography , Infant Mortality , Ultrasonography, Prenatal , Perinatal Mortality
11.
Rev. bras. ginecol. obstet ; 41(1): 17-23, Jan. 2019. tab
Article in English | LILACS | ID: biblio-1003519

ABSTRACT

Abstract Objective To assess and compare the sensitivity and specificity of ultrasonography and magnetic resonance imaging in the diagnosis of placenta accreta in patients with placenta previa. Methods This retrospective cohort study included 37 women, and was conducted between January 2013 and October 2015; 16 out of the 37 women suffered from placenta accreta. Histopathology was considered the gold standard for the diagnosis of placenta accreta; in its absence, a description of the intraoperative findings was used. The associations among the variables were investigated using the Pearson chi-squared test and the Mann-Whitney U-test. Results The mean age of the patients was 31.8 ± 7.3 years, the mean number of pregnancies was 2.8 ± 1.1, the mean number of births was 1.4 ± 0.7, and the mean number of previous cesarean sections was 1.2 ± 0.8. Patients with placenta accreta had a higher frequency of history of cesarean section than those without it (63.6% versus 36.4% respectively; p < 0.001). The mean gestational age at birth among women diagnosed with placenta previa accreta was 35.4 ± 1.1 weeks. The mean birth weight was 2,635.9 ± 374.1 g. The sensitivity of the ultrasound was 87.5%, with a positive predictive value (PPV) of 65.1%, and a negative predictive value (NPV) of 75.0%. The sensitivity of the magnetic resonance imaging was 92.9%, with a PPV of Conclusion The ultrasound and the magnetic resonance imaging showed similar sensitivity and specificity for the diagnosis of placenta accreta.


Resumo Objetivo Avaliar e comparar a sensibilidade e especificidade da ultrassonografia e da ressonância magnética no diagnóstico do acretismo placentário em pacientes com placenta prévia. Métodos Estudo de coorte retrospectivo com 37 mulheres, sendo 16 com acretismo placentário, realizado de janeiro de 2013 a outubro de 2015. Considerou-se padrãoouro para o diagnóstico de acretismo placentário o exame anatomopatológico, sendo que, na sua ausência, a descrição do achado intraoperatório. As associações entre variáveis foram investigadas utilizando o teste qui-quadrado de Pearson e o teste U de Mann-Whitney. Resultados A idade média foi de 31,8 ± 7,3 anos, o número médio de gestações foi de 2,8 ± 1,1, o número médio da quantidade de partos foi de 1,4 ± 0,7, e o número médio de cesáreas prévias foi de 1,2 ± 0,8. O grupo do acretismo placentário apresentou antecedente de cesariana mais frequentemente do que o grupo sem acretismo (63,6% versus 36,4%, respectivamente; p < 0,001). A idade gestacional no parto em mulheres com diagnóstico de placenta prévia com acretismo foi de 35,4 ± 1,1 semanas. O peso ao nascer médio foi de 2.635,9 ± 374,1 g. A sensibilidade do ultrassom foi de 87,5%, comvalor preditivo positivo (VPP) de 65,1%, e valor preditivo negativo (VPN) de 75,0%. Para a ressonância magnética, a sensibilidade foi de 92,9%, com VPP de 76,5% e VPN de 75,0%. O índice kappa para concordância entre os dois testes foi de 0,69 (intervalo de confiança de 95% [IC95%]: 0,26-1,00). Conclusão O ultrassom e a ressonância magnética apresentaram sensibilidade e especificidade semelhantes no diagnóstico do acretismo placentário.


Subject(s)
Humans , Female , Pregnancy , Adult , Placenta Accreta/diagnostic imaging , Magnetic Resonance Imaging , Ultrasonography, Prenatal , Prenatal Diagnosis/methods , Retrospective Studies , Cohort Studies , Sensitivity and Specificity
12.
Rev. inf. cient ; 98(1): 127-139, 2019. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-1016610

ABSTRACT

Introducción: la sirenomelia data del siglo XVI, etapa en que los afectados se suponían "monstruos", y eran sacrificados u ocultadospor las familias. Incurre a escala mundial y en todas las razas. Es más frecuente en los varones, en embarazos gemelares monocigóticos y en hijos de madre menores de 20 o mayores de 40 años. Objetivo: socializar la experiencia del diagnóstico prenatal de la sirenomelia, a fin de sistematizar referentes teóricos que familiaricen a los médicos generales con las características clínicas, la etiopatogenia y el diagnóstico de esta enfermedad, multisistémica y letal. Método: se presentaron dos casos de sirenomelia diagnosticados por ecografía prenatal en el Hospital General Docente "Dr. Agostinho Neto" de Guantánamo durante los años 2014-2017. Resultados: se estableció el diagnóstico definitivo de sirenomelia tipo I y tipo II según la clasificación de Stocker y Heifetzy Simelia Dipus de acuerdo con los criterios de Foerster. Conclusiones: la actuación profesional debe dirigirse al diagnóstico prenatal, a fin de orientar la interrupción del embarazo pues no se disponen de intervenciones médicas para mejorar el pronóstico del feto o del recién nacido con sirenomelia(AU)


Introduction: the sirenomelia dates from the sixteenth century,stage in which those affected were supposed to be "monsters", and were sacrificed or hidden by families. It happens on a worldwide scale and in all races. It is more common in males, in monozygotic twin pregnancies and in children of mothers under 20 or over 40 years. Objective: to socialize the experience of prenatal diagnosis of sirenomelia, in order to systematize theoretical references that familiarize general practitioners with the clinical characteristics, the etiopathogenesis and the diagnosis of this disease, multisystemic and lethal. Method: Two cases of sirenomelia diagnosed by prenatal ultrasound were presented at the "Dr. Agostinho Neto Hospital" in Guantánamo during the years 2014-2017. Results: the definitive diagnosis of type I and type II sirenomelia was established according to the classification of Stocker and Heifetzy Simelia Dipus according to the Foerster criteria. Conclusions: the professional performance should be directed to the prenatal diagnosis, in order to guide the interruption of the pregnancy since medical interventions are not available to improve the prognosis of the fetus or the newborn with sirenomelia(AU)


Introdução: datas Sirenomelia desde a fase século XVI, onde afetadas "monstros" deveriam, e foram abatidos ou oculta pelo famílias. Acontece em escala mundial e em todas as raças. É mais comum em homens, em gêmeos monozigóticos mãe gestações gemelares e crianças com menos de 20 ou mais de 40 anos. Objetivo: socializar a experiência de diagnóstico pré-natal de sirenomelia, a fim de sistematizar quadro teórico que os clínicos gerais familiarizadas com os achados clínicos, patogênese e diagnóstico desta doença, multisystem e letal. Método: dois casos de sirenomelia diagnosticados por ultra-som pré-natal no Hospital Agostinho Neto Guantanamo durante os anos 2014-2017 foram apresentados. Resultados: o diagnóstico final de II Sirenomelia estabelecidos como classificado por Stocker e Heifetzy Simelia dipus de acordo com critérios Foerster tipo I e tipo. Conclusões: o desempenho deve ser direcionado para diagnóstico pré-natal, para orientar a interrupção da gravidez não estão disponíveis para intervenções médicas para melhorar o prognóstico do feto ou recémnascido com sirenomelia(AU)


Subject(s)
Humans , Female , Pregnancy , Prenatal Diagnosis/methods , Congenital Abnormalities/embryology , Ectromelia/diagnostic imaging
13.
Rev. salud pública ; 20(4): 479-483, jul.-ago. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-979010

ABSTRACT

RESUMEN Objetivo Determinar la seroprevalencia de anticuerpos IgG anti-rubéola y anti-citomegalovirus en un grupo de mujeres entre 16 y 40 años, residentes en Tunja. Métodos Investigación descriptiva de corte transversal, en la cual se incluyeron mujeres de 16 a 40 años, por medio de un muestreo no probabilístico por conveniencia. Las variables sociodemográficas fueron registradas mediante encuesta. Se empleó ensayo inmunoenzimático para la determinación cuantitativa de anticuerpos IgG frente a rubéola y citomegalovirus en suero. La estadística aplicada al estudio se llevó a cabo por medio del programa estadístico SPSS versión 21. Resultados El estudio incluyó un total de 154 mujeres en edad fértil, estableciéndose una seropositividad para IgG anti-rubéola de 96,1% (n=148) (IC 95% 93,0 - 99,1) y anti-citomegalovirus de 90,9% (n=140) (IC 95% 86,3 - 95,4). Conclusión Una de cada diez mujeres en estudio está en riesgo de adquirir una infección primaria por citomegalovirus y una de cada 30 por rubéola. El control prenatal por medio de determinaciones serológicas frente a citomegalovirus y rubéola durante el embarazo es primordial en estos casos.(AU)


ABSTRACT Objective To determine the seroprevalence of anti-rubella and anti-cytomegalovirus IgG antibodies in a group of women aged between 16 and 40 years, residents of Tunja. Methods Descriptive, cross-sectional research in women aged between 16 and 40 years included by means of non- probability sampling for convenience. Sociodemographic variables were recorded by applying a survey. An enzyme immunoassay was used for the quantitative determination of rubella and cytomegalovirus IgG antibodies in serum. The statistical analysis was carried out using the statistical program SPSS version 21. Results The study included 154 women of childbearing age, establishing seropositivity for anti-rubella IgG of 96.1% (n=148) (95%CI: 86.3 - 95.4) Conclusion One in ten women included in the study is at risk of primary cytomegalo-virus infection and one in 30 of rubella infection. Prenatal care using serological determinations of cytomegalovirus and rubella during pregnancy is essential in these cases.(AU)


Subject(s)
Humans , Female , Pregnancy , Prenatal Diagnosis/methods , Rubella Syndrome, Congenital/immunology , Cytomegalovirus Infections/immunology , Antibodies, Viral , Seroepidemiologic Studies , Epidemiology, Descriptive , Cohort Studies
14.
Rev. medica electron ; 40(4): 1059-1069, jul.-ago. 2018. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-961280

ABSTRACT

Introducción: los defectos de pared abdominal constituyen un espectro de malformaciones anatómicas estructurales de etiología diversa, con severidad y pronóstico variable. Los factores de riesgo son disímiles, muchos modificables. Objetivo: identificar los factores de riesgo asociados a defectos de pared abdominal diagnosticados prenatalmente en la provincia de Matanzas. Materiales y métodos: se realizó una investigación de corte transversal sobre los factores de riesgo en las mujeres con diagnóstico de defectos de pared abdominal en la provincia Matanzas, de enero 2013 a enero 2016, a través de una encuesta, previa prueba piloto para cálculo de confiabilidad (alfa de Cronbach) y validez (regresión lineal). Resultados: el valor de ambos coeficientes fue superior a 0.7, por lo que la encuesta fue confiable y válida. Los factores de riesgo para estos defectos más frecuentes fueron la combinación de factores ambientales, no suplementación periconcepcional de ácido fólico y exposición a sustancias químicas. La necesidad de recibir información preconcepcional de las mujeres fue alta. Conclusiones: los factores de riesgo más frecuentes fueron la combinación de factores ambientales y la no suplementación periconcepcional de ácido fólico (AU).


Introduction: the defects of the abdominal wall are a spectrum of structural anatomic malformations of diverse etiology, with variable severity and prognosis. The risk factors are dissimilar, many of them modifiable. Objective: to identify the risk factors associated to abdominal wall defects diagnosed before birth in the province of Matanzas. Materials and methods: a cross-sectional research was carried out on the risk factors in women with diagnose of defects of the abdominal wall in the province of Matanzas, from January 2013 to January 2016, through an inquiry, after a pilot test to calculate reliability (Crombach alpha), and validity (lineal regression). Results: the value of both coefficients was higher than 0.7, so the inquiry was reliable and valid. The risk factors for these more frequent defects were the combination of environmental factors, the lack of peri conceptional supplementation of folic acid and exposition to chemical substances. The necessity of receiving pre-conceptional information from the part of the women was high. Conclusions: the more frequent risk factors were the combination of environmental factors and the lack of peri conceptional supplementation of folic acid (AU).


Subject(s)
Humans , Female , Women , Risk Factors , Abdominal Wall/abnormalities , Prenatal Diagnosis/methods , Prenatal Diagnosis/mortality , Primary Prevention/methods , Congenital Abnormalities/diagnosis , Environmental Hazards
15.
Arch. argent. pediatr ; 116(4): 621-625, ago. 2018. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-950055

ABSTRACT

La vena cava inferior (VCI) está constituida por tres segmentos de diferente origen embriológico. De su mala fusión, surge un amplio espectro de anomalías. La prevalencia de anomalías de la VCI es de 0,07-8,7% de la población. Generalmente, se diagnostica como hallazgo incidental en la vida adulta. Representa el 5-9,5% de las trombosis venosas profundas idiopáticas en menores de 30 años sin factores de riesgo asociados. Se presenta a una recién nacida a término con diagnóstico prenatal de ascitis en la semana 20 de gestación. Se diagnosticó, mediante angiotomografía abdominal, la agenesia de VCI. El tratamiento de pacientes con agenesia de la VCI se basa en el manejo de las complicaciones. Debido al mayor riesgo que presentan de sufrir un evento trombótico, se debe considerar la profilaxis antitrombótica a largo plazo. Se recomienda iniciar profilaxis anticoagulante en la pubertad.


Inferior Vena Cava (IVC) is composed of three segments from different embryological origin. Its lack of fusion originates a wide spectrum of anomalies of the IVC. These malformations are present in 0.07-8.7% of the population. It is generally diagnosed as an incidental finding in adult life. It represents between 5 and 9.5% of idiopathic deep vein thrombosis in patients younger than 30 years old without associated risk factors. We present a case of a term newborn with prenatal diagnosis of ascites during the 20th week of gestation. IVC Agenesis was diagnosed with the use of abdominal angiotomography. The treatment of patients with IVC Agenesis is based on the management of its complications. Due to the increased thrombotic risk of these patients, we should consider lifelong anticoagulation. We suggest initiating it during puberty.


Subject(s)
Humans , Female , Infant, Newborn , Prenatal Diagnosis/methods , Ascites/etiology , Vena Cava, Inferior/abnormalities , Vena Cava, Inferior/diagnostic imaging , Pregnancy , Computed Tomography Angiography/methods
16.
Rev. bras. ginecol. obstet ; 40(7): 384-389, July 2018. tab
Article in English | LILACS | ID: biblio-959015

ABSTRACT

Abstract Objective The main objective of this study was to examine the diagnostic performance of the first-trimester combined test for aneuploidies in unselected pregnancies from Rio de Janeiro and compare it with the examples available in the literature. Methods We investigated 3,639 patients submitted to aneuploidy screening from February 2009 to September 2015. The examination is composed of the Fetal Medicine Foundation risk evaluation based on nuchal translucency evaluation, mother's age, presence of risk factors, presence of the nasal bone and Doppler of the ductus venous in addition to biochemical analysis of pregnancy-associated plasma protein A (PAPP-A) and beta-human chorionic gonadotropin (β-hCG) markers. The cut-off point for high risk for aneuploidies was defined as greater than 1:100, with intermediate risk defined between 1:100 and 1:1,000, and low risk defined as less than 1:1,000. The variable aneuploidy was considered as a result not only of trisomy of chromosome 21 but also trisomy of chromosomes 13 and 18. Results Excluding the losses, the results of 2,748 patients were analyzed. The firsttrimester combined test achieved 71.4% sensitivity with a 7.4% false-positive (FP) rate, specificity of 92.6%, positive predictive value (PPV) of 6.91% and negative predictive value (NPV) of 99.76%, when the cut-off point considered was greater than 1:1,000. Through a receiving operating characteristics (ROC) curve, the cut-off point that maximized the sensitivity and specificity for the diagnosis of aneuploidies was defined as 1:1,860. When we adjusted the false-positive (FP) rate to 5%, the detection rate for this analysis is 72.7%, with a cut-off point of 1:610. Conclusion The combined test of aneuploidy screening showed a detection rate inferior to those described in the literature for a higher FP rate.


Resumo Objetivo O objetivo principal deste estudo foi examinar o desempenho diagnóstico do rastreio combinado de aneuploidias do primeiro trimestre em gestações não selecionadas do Rio de Janeiro e compará-lo com os exemplos disponíveis na literatura. Métodos Investigamos 3.639 pacientes submetidas à triagem para aneuploidia, de fevereiro de 2009 a setembro de 2015. O exame é composto pela avaliação do risco da FetalMedicine Foundation combase na avaliação da translucência nucal, idade da mãe, presença de fatores de risco, presença de osso nasal e Doppler do ducto venoso, além da análise bioquímica dos marcadores proteína A plasmática associada à gravidez (PAPP-A) e gonadotrofina coriônica humana-beta (β-hCG). O ponto de corte para alto risco de aneuploidias foi definido como superior a 1:100, para risco intermediário foi definido entre 1: 100 e 1: 1.000 e para baixo risco foi definido como inferior a 1:1.000. A variável aneuploidia foi considerada não apenas como resultado da trissomia do cromossomo 21, mas também da trissomia dos cromossomos 13 e 18. Resultados Excluindo as perdas, foram analisados os resultados de 2.748 pacientes. O teste combinado do primeiro trimestre alcançou 71,4% de sensibilidade com uma taxa de falsos positivos (FPs) de 7,4%, especificidade de 92,6%, (valor preditivo positivo) VPP de 6,91% e (valor preditivo negativo) VPN de 99,76%, quando o ponto de corte considerado foi maior que 1:1.000. Através de uma curva de característica de operação do receptor (COR), o ponto de corte que maximizou a sensibilidade e especificidade para o diagnóstico de aneuploidias foi de 1:1.860. Quando corrigimos a taxa de FP para 5%, a taxa de detecção para esta análise é de 72,7%, com um ponto de corte de 1:610. Conclusão O rastreio combinado de aneuploidia mostrou uma taxa de detecção inferior à descrita na literatura para uma maior taxa de FP.


Subject(s)
Humans , Female , Adolescent , Adult , Young Adult , Prenatal Diagnosis/methods , Algorithms , Aneuploidy , Pregnancy Trimester, First , Brazil , Risk , Predictive Value of Tests , Sensitivity and Specificity , Middle Aged
17.
Arch. argent. pediatr ; 116(3): 409-420, jun. 2018. tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-950018

ABSTRACT

La secuencia de bandas amnióticas es un desorden congénito caracterizado por anomalías craneofaciales, de la pared corporal y de las extremidades que pueden asociarse con bandas fibrosas fetoplacentarias. Su prevalencia ha sido reportada entre 0,19 y 8,1 por 10 000 nacimientos. Diversas teorías han tratado de explicar su etiología, sin embargo, ninguna, en forma individual, sustenta todas y cada una de las anomalías observadas, por lo que se ha considerado una entidad multifactorial. La identificación de anomalías (pre-yposnatalmente) sugestivas de secuencia de bandas amnióticas permite el abordaje diagnóstico para efectuar intervenciones terapéuticas oportunas que posibiliten la liberación de bandas amnióticas mediante fetoscopia con recuperación de la perfusión de la porción distal de la extremidad involucrada o bien la reparación quirúrgica posnatal y para otorgar asesoramiento genético. Este artículo ofrece una actualización sobre aspectos epidemiológicos, teorías etiológicas, factores de riesgo, características clínicas, diagnóstico (que incluye el diagnóstico prenatal), asesoramiento genético, abordaje terapéutico y pronóstico de esta entidad.


Amniotic bands sequence is a congenital disorder characterized by craniofacial, body wall, and limb anomalies that may be associated with fetal-placental fibrous bands. Its prevalence has been reported to range from 0.19 to 8.1 per 10 000births. Different theories have attempted to explain the etiology of amniotic band sequence; however, none has individually been able to support each and every defect observed, so it has been considered to be a multifactorial condition. The (pre- and post-natal) identification of anomalies suggestive of amniotic band sequence is useful for the diagnostic approach and implementation of timely therapeutic interventions favoring the release of the amniotic bands using fetoscopy with recovery of the involved distal limb perfusion, or else the possibility of performing a post-natal surgical repair. It is also helpful to provide genetic counseling. This article offers an update on the epidemiological aspects, etiological theories, risk factors, clinical characteristics, diagnosis (including antenatal diagnosis), genetic counseling, therapeutic approach, and prognosis of amniotic bands sequence.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Prenatal Diagnosis/methods , Fetoscopy/methods , Amniotic Band Syndrome/diagnosis , Prognosis , Prevalence , Risk Factors , Genetic Counseling/methods , Amniotic Band Syndrome/surgery , Amniotic Band Syndrome/epidemiology
18.
Bol. méd. Hosp. Infant. Méx ; 75(2): 119-126, mar.-abr. 2018. graf
Article in Spanish | LILACS | ID: biblio-951299

ABSTRACT

Resumen Introducción: Las malformaciones pulmonares congénitas son una causa poco frecuente de morbilidad neonatal. Algunas de ellas tienen un origen común, lo que permite identificar lesiones combinadas. Su diagnóstico puede realizarse de forma prenatal mediante ultrasonido, con las limitaciones de que solo se realiza en centros especializados y que depende de la pericia del operador. La asociación entre el secuestro pulmonar y la malformación congénita de la vía aérea se ha descrito aproximadamente en 40-60 casos desde 1949, cuando se observó por primera vez. Muchas lesiones no son perceptibles en la vida intrauterina. Sin embargo, en el periodo neonatal se presentan síntomas respiratorios recurrentes que en algunos casos están asociados con una malformación pulmonar. Caso clínico: Se presenta el caso de una lactante diagnosticada con secuestro pulmonar a las 24 semanas de edad gestacional. Recibió tratamiento quirúrgico intrauterino con reporte de resolución completa de la malformación en ultrasonidos posteriores. Fue valorada por neumología pediátrica a los 4 meses de edad. Se realizó una angiotomografía y se confirmó la presencia de secuestro pulmonar, por lo que se realizó una lobectomía. El estudio histopatológico reportó secuestro pulmonar extralobar con malformación congénita de la vía aérea pulmonar tipo 2. Estas lesiones combinadas se identificaron mediante un estudio histopatológico. El tratamiento de elección fue quirúrgico. Conclusiones: Ante la confirmación de una malformación, destaca la importancia de realizar la búsqueda de otras malformaciones que pudieran estar asociadas.


Abstract Introduction: Congenital pulmonary malformations are a rare cause of neonatal morbidity. Some of them have a common origin, which allows the identification of combined lesions. Its diagnosis can be made prenatally by ultrasound, with the limitation that this study is performed in specialized centers and depends on the expertise of the operator. The association of pulmonary sequestration and congenital malformation of the airway has been described in approximately 40-60 cases since its first description in 1949. Many lesions are not perceptible in intrauterine life and in the neonatal period there are recurrent respiratory symptoms that in some cases are associated with a congenital pulmonary malformation. Case report: We report the case of a young infant, who was diagnosed with pulmonary sequestration at 24 weeks of gestational age, undergoing intrauterine surgical treatment with a report of complete resolution of the malformation in posterior ultrasounds. She was valued by pediatric pneumology at 4 months of age, where angiotomography was performed and the presence of pulmonary sequestration was confirmed by lobectomy. The histopathological study reported extralobar pulmonary sequestration with congenital malformation of the pulmonary airway type 2. These combined lesions were identified by histopathological study. The treatment of choice was surgical. Conclusions: Upon the confirmation of a malformation, we emphasize the importance of performing a screening in order to search for other that could be associated.


Subject(s)
Female , Humans , Infant , Prenatal Diagnosis/methods , Respiratory System Abnormalities/diagnosis , Bronchopulmonary Sequestration/diagnosis , Pneumonectomy/methods , Respiratory System Abnormalities/surgery , Bronchopulmonary Sequestration/surgery , Gestational Age , Fetal Therapies/methods , Computed Tomography Angiography/methods
20.
Clinics ; 72(7): 400-404, July 2017. tab
Article in English | LILACS | ID: biblio-890711

ABSTRACT

OBJECTIVES: Quantitative fluorescence polymerase chain reaction (QF-PCR) is a rapid and reliable method for screening aneuploidies, but in Brazil, it is not used in public services. We investigated the accuracy of QF-PCR for the prenatal recognition of common aneuploidies and compared these results with cytogenetic results in our laboratory. METHOD: A ChromoQuant QF-PCR kit containing 24 primer pairs targeting loci on chromosomes 21, 13, 18, X and Y was employed to identify aneuploidies of the referred chromosomes. RESULTS: A total of 162 amniotic fluid samples analyzed using multiplex QF-PCR were compared with karyotyping analysis. The QF-PCR results were consistent with the results of cytogenetic analysis in 95.4% of all samples. CONCLUSION: QF-PCR was demonstrated to be efficient and reliable for prenatal aneuploidy screening. This study suggests that QF-PCR can be used as a rapid diagnostic method. However, rearrangements and some mosaic samples cannot be detected with this test; thus, those exceptions must undergo cytogenetic analysis.


Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Middle Aged , Young Adult , Prenatal Diagnosis/methods , Polymerase Chain Reaction/methods , Aneuploidy , Brazil , Prospective Studies , Cytogenetic Analysis , Fluorescence , Karyotyping
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