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The vanishing twin: An explanation for discordance between chorionic villus karyotype and fetal phenotype
Authors:K S Reddy  M B Petersen  S E Antonarakis  K J Blakemore
Institution:1. Center of Medical Genetics, Pediatrics and Genetics, The Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, Maryland. U.S.A.;2. Department of Gynecology and Obstetrics, The Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, Maryland. U.S.A.
Abstract:One ‘erroneous’ diagnosis occurred in 200 first-trimester chorionic villus samples (CVS) analysed. In direct preparations following 24 h incubation as well as in long-term cultures, a 46.XX karyotype was observed in the villi (28 and 25 cells, respectively). At 20 weeks of gestation, labour was induced because of fetal death in utero. An autopsy performed on the fetus revealed a male phenotype. Placenta and fetal tissues were not submitted for cytogenetic studies. The discordant CVS karyotype (46,XX), in view of the male fetal phenotype, prompted further cytogenetic and molecular studies. Chromosome marker studies on the parents' blood and chorionic villi confirmed both maternal and paternal inheritance of chromosomes in the CVS. DNA studies on formalin-fixed skin using a Y-specific probe, DYZ1, confirmed the presence of a Y chromosome in the fetus. The most likely cause of the discrepant CVS karyotype is the presence of an undetected degenerating dizygotic twin.
Keywords:CVS 46  XX  Male fetus DYZ1+ve  Dizygotic twin
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