Multicenter clinical experience with non-invasive cell-free DNA screening for monosomy X and related X-chromosome variants

Objective

We aimed to investigate how the presence of fetal anomalies and different X chromosome variants influences Cell-free DNA (cfDNA) screening results for monosomy X.

Methods

From a multicenter retrospective survey on 673 pregnancies with prenatally suspected or confirmed Turner syndrome, we analyzed the subgroup for which prenatal cfDNA screening and karyotype results were available. A cfDNA screening result was defined as true positive (TP) when confirmatory testing showed 45,X or an X-chromosome variant.

Results

We had cfDNA results, karyotype, and phenotype data for 55 pregnancies. cfDNA results were high risk for monosomy X in 48/55, of which 23 were TP and 25 were false positive (FP). 32/48 high-risk cfDNA cases did not show fetal anomalies. Of these, 7 were TP. All were X-chromosome variants. All 16 fetuses with high-risk cfDNA result and ultrasound anomalies were TP. Of fetuses with abnormalities, those with 45,X more often had fetal hydrops/cystic hygroma, whereas those with “variant” karyotypes had different anomalies.

Conclusion

Both, 45,X or X-chromosome variants can be detected after a high-risk cfDNA result for monosomy X. When there are fetal anomalies, the result is more likely a TP. In the absence of fetal anomalies, it is most often an FP or X-chromosome variant.     

Methyl tert-butyl ether (MTBE) in finished drinking water in Germany

In the present study 83 finished drinking water samples from 50 cities in Germany were analyzed for methyl tert-butyl ether (MTBE) content with a detection limit of 10 ng/L. The detection frequency was 46% and the concentrations ranged between 17 and 712 ng/L. Highest concentrations were found in the community water systems (CWSs) of Leuna and Spergau in Saxony-Anhalt. These CWSs are supplied with water possibly affected by MTBE contaminated groundwater. MTBE was detected at concentrations lower than 100 ng/L in drinking water supplied by CWSs using bank filtered water from Rhine and Main Rivers. The results from Leuna and Spergau show that large groundwater contaminations in the vicinity of CWSs pose the highest risk for MTBE contamination in drinking water. CWSs using bank filtered water from Rhine and Main Rivers are susceptible to low MTBE contaminations in finished drinking water. All measured MTBE concentrations were below proposed limit values for drinking water.