Syndromic associations with congenital anomalies of the fetal thorax and abdomen

Anomalies of the thorax and abdomen can be found in a number of genetic syndromes. Whilst it may not be possible to make a definitive diagnosis before birth, knowledge of the potential associations can be useful for the prenatal diagnostician when examining the fetus and counselling the parents. In this article, we describe conditions where other features may be detectable using prenatal ultrasound. We describe the features, potential diagnostic aids and prognosis. The tables list other potential features that may be identified. The range of conditions that can occur emphasises the value of genetic input in the management of a fetus with an apparently normal karyotype and multiple anomalies, the need to save material for future molecular analysis and the requirement of a detailed examination after delivery. These are needed in order to make accurate diagnoses and advise parents with regard to recurrence risks and the potential for prenatal diagnosis in future pregnancies. Copyright © 2008 John Wiley & Sons, Ltd.     

Increased fetal nuchal translucency at 11–14 weeks

Nuchal translucency (NT) is the sonographic appearance of a subcutaneous collection of fluid behind the fetal neck. The measurement of fetal NT thickness at the 11–14-week scan has been combined with maternal age to provide an effective method of screening for trisomy 21; for an invasive testing rate of 5%, about 75% of trisomic pregnancies can be identified. When maternal serum free-β human chorionic gonadotrophin (β-hCG) and pregnancy-associated plasma protein-A (PAPP-A) at 11–14 weeks are also taken into account, the detection rate of chromosomal defects is about 90%. Increased NT can also identify a high proportion of other chromosomal abnormalities and is associated with major defects of the heart and great arteries, and a wide range of skeletal dysplasias and genetic syndromes. In monochorionic twins, discordancy for increased NT is an early marker of twin-to-twin transfusion syndrome (TTTS). As with the introduction of any new technology into routine clinical practice, it is essential that those undertaking the 11–14-week scan are adequately trained and their results are subjected to rigorous audit. Copyright © 2002 John Wiley & Sons, Ltd.     

农药氰戊菊酯和三氟氯氰菊酯对蚕豆根尖细胞的遗传损伤

采用蚕豆根尖微核技术研究了农药氰戊菊酯、三氟氯氰菊酯对蚕豆根尖细胞的遗传损伤.测定了不同浓度氰戊菊酯、三氟氯氰菊酯(5×10-10～5×10-2g·L-1)诱导下的蚕豆根尖细胞微核率、有丝分裂指数和染色体畸变率.结果表明,氰戊菊酯、三氟氯氰菊酯均能诱发较高的微核率,在一定浓度范围内,微核率随两种农药处理浓度的升高而增加,但随着处理浓度的进一步升高微核率反而呈下降趋势;两种农药均可使蚕豆根尖细胞有丝分裂指数增大;并能诱导蚕豆根尖细胞产生较高频率、多种类型的染色体畸变.氰戊菊酯和三氟氯氰菊酯对蚕豆根尖细胞具有明显的遗传毒性.     

Unusual case of a fetus with congenital cystic adenomatoid malformation of the lung associated with trisomy 13

Congenital cystic adenomatoid malformation of the lung can be detected with antenatal ultrasound as hyperechogenic areas in the fetal chest. Associated extrapulmonary malformations as well as chromosomal aberrations are described as very rare. We present a case report of a fetus in the 23rd week of gestation who showed in the course of a routine ultrasound screening a large number of malformations: holoprosencephaly, arrhinencephaly, cleft palate, CCAM type III of the right inferior pulmonary lobe, ventricular septal defect and bilateral clubfeet. Chromosome analysis confirmed the suspicion of trisomy 13. The present case shows how important it is—even with malformations that are rarely accompanied by associated anomalies and which have a very good prognosis—to carry out a directed diagnosis including a fetal karyotyping. Copyright © 2003 John Wiley & Sons, Ltd.