• Title/Summary/Keyword: Fetal diagnosis

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An overview of current knowledge about cell-free RNA in amniotic fluid

  • Jung, Yong Wook;Shin, Yun Jeong;Shim, Sung Han;Cha, Dong Hyun
    • Journal of Genetic Medicine
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    • v.13 no.2
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    • pp.65-71
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    • 2016
  • Cell-free nucleic acids (cf-NAs) originate in trophoblasts and are detected in the maternal plasma. Using innovative bioinformatic technologies such as next-generation sequencing, cf-NAs in the maternal plasma have been rapidly applied in prenatal genetic screening for fetal aneuploidy. Amniotic fluid is a complex and dynamic fluid that provides growth factors and protection to the fetus. In 2001, the presence of cf-NA in amniotic fluid was reported. Amniotic fluid is in direct contact with the fetus and is derived from fetal urine and maternal and fetal plasma. Therefore, these genetic materials have been suggested to reflect fetal health and provide real-time genetic information regarding fetal development. Recently, several studies evaluated the global gene expression changes of amniotic fluid cell-free RNA according to gestational age. In addition, by analyzing the transcriptome in the amniotic fluid of fetal aneuploidy, potential key pathways and novel biomarkers for fetal chromosomal aneuploidy were identified. Here, we review the current knowledge of cell-free RNA in amniotic fluid and suggest future research directions.

The activity of factor VIII and IX of cord blood at mid-trimester in fetuses without hemophilia

  • Choe, David Kwang Yong;Oh, Jeong Won;Jun, Jong Kwan;Choi, Young Min
    • Journal of Genetic Medicine
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    • v.13 no.2
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    • pp.89-94
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    • 2016
  • Purpose: Molecular genetic analysis is the main approach used for prenatal diagnosis of hemophilia A and B. However, in certain cases, such analysis is uninformative. In such situations, direct measurement of fetal coagulation factor levels is still the best option, and it may be the only option in some cases. This study was conducted to determine the normal ranges of mid-trimester cord blood factor VIII (FVIII) and IX (FIX) in a Korean population. Materials and Methods: Twenty-six FVIII samples and 29 FIX samples were assayed in fetal cord blood acquired by ultrasound-guided cordocentesis. Sampling was conducted during gestational ages of 19-24 weeks. Results: The mean and standard deviations for FVIII and FIX activity were $45.5{\pm}30.5%$ and $19.9{\pm}12.2%$, respectively. Ranges for FVIII and FIX were 1.5-125.0% and 6.0-52.0%, respectively. Conclusion: Our study revealed the normal ranges and lowest level of factor VIII and factor IX in non-affected normal fetus by fetal cord blood sampling during the mid-trimester in a Korea population. The factor assay of the fetal cord blood is invasive but feasible and provides important basic data related to hemophilia.

Congenital Long QT Syndrome Type 8 Characterized by Fetal Onset of Bradycardia and 2:1 Atrioventricular Block

  • Joo, Donghoon;Lee, Hyoung Doo;Kim, Taehong;Ko, Hoon;Byun, Joung-Hee
    • Neonatal Medicine
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    • v.28 no.1
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    • pp.59-63
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    • 2021
  • An important, albeit rare, cause of fetal bradycardia is long QT syndrome (LQTS). Congenital LQTS is an ion channelopathy caused by mutations in genes encoding cardiac ion channel proteins. Fetal onset of LQTS imposes high risk of life-threatening tachyarrhythmias and sudden cardiac death. Here, we report the case of a female newborn with fetal onset of bradycardia and a 2:1 atrioventricular (AV) block. After birth, a 12-lead electrocardiogram (ECG) revealed bradycardia with QT prolongation of a corrected QT (QTc) interval of 680 ms and pseudo 2:1 AV block. Genetic testing identified a heterozygous Gly402Ser (c.1204G>A) mutation in CACNA1C, confirming the diagnosis of LQTS type 8 (LQT8). The patient received propranolol at a daily dose of 2 mg/kg. Mexiletine was subsequently administered owing to the sustained prolongation of the QT interval and pseudo 2:1 AV block. One week after mexiletine inception, the ECG still showed QT interval prolongation (QTc, 632 ms), but no AV block was observed. There were no life-threatening tachyarrhythmias in a follow-up period of 13 months.

Fetal Lung Interstitial Tumor: A Comprehensive Case Study with an Emphasis on Next-Generation Sequencing

  • Yoo Jin Jung;Seongyeon Jung;Jiwon Koh;Jaemoon Koh;Yoon Kyung Jeon;Sung-Hye Park;Eun Na Kim;Chang Hyun Kang
    • Journal of Chest Surgery
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    • v.57 no.4
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    • pp.408-412
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    • 2024
  • Fetal lung interstitial tumor (FLIT), which is characterized by immature interstitial cells resembling the fetal lung parenchyma of 20 to 24 weeks of gestation, is a rare respiratory neoplasm. This study presents the first reported FLIT in Korea. It also aims to refine the diagnostic method of FLIT and increase the accuracy of prognostic assessment by using next-generation sequencing to check for anaplastic lymphoma receptor tyrosine kinase (anaplastic lymphoma kinase) gene rearrangement. Although the initial prognosis for FLIT has been promising since its first report in 2010, certain pathological features are associated with poorer outcomes. Therefore, achieving an accurate diagnosis of FLIT is crucial for avoiding unnecessary treatments beyond surgical resection.

Time of Initial Detection of the Gestational Structures by Ultrasonography Examination in Small Pet Dogs (소형 애완견에서 초음파 검사에 의한 임신 구조물의 최초 관찰 시기)

  • Park, Sang-Guk;Kim, Bang-Sil;Yun, Chang-Jin;Yeo, Woon-Chang;Park, Chul-Ho;Kim, Jae-Pung;Lee, Suk-Kyung;Moon, Jin-San;Suh, Guk-Hyun;Oh, Ki-Seok;Son, Chang-ho
    • Journal of Embryo Transfer
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    • v.23 no.1
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    • pp.5-11
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    • 2008
  • Serial ultrasonographic examinations were daily performed from 15 days after ovulation until parturition to determine the time of first detection and ultrasonographic appearance of the fetal and extra-fetal structures in pregnant 10 Maltese, 10 Yorkshire Terrier, 15 Shih-tzu, and 10 Miniature Schnauzer bitches, respectively. Gestational age was timed from the day of ovulation (day 0), which was estimated to occur when plasma progesterone concentration was first increased above 4.0ng/ml. The gestational length was $63.4{\sim}63.6$ (range: $61{\sim}65$) days and the geatational length was no statistically significant difference among bitches (p>0.05). The initial detection of the extra-fetal structures were; gestational sac at days $18.9{\sim}19.5\;(17{\sim}22)$, zonary placenta at days $24.6{\sim}25.5\;(23{\sim}28)$, yolk sac membrane at days $24.6{\sim}25.5\;(23{\sim}27)$, yolk sac tubular shape at days $26.1{\sim}26.3\;(24{\sim}28)$, and amniotic membrane at days $26.1{\sim}28.2\;(24{\sim}31)$, respectively. The time of the first detection of the extra-fetal structures were no statistically significant difference among bitches (p>0.05). The initial detection of the fetal structures were; embryo initial detection at days $22.5{\sim}22.9\;(21{\sim}24)$, heartbeat at days $23.2{\sim}23.8\;(21{\sim}25)$, embryo bipolar shape $27.6{\sim}28.9\;(26{\sim}30)$, fetal movement at days $31.9{\sim}32.8\;(27{\sim}34)$, limb buds at days $29.1{\sim}30.7\;(27{\sim}33)$, stomach at days $31.1{\sim}33.1\;(29{\sim}34)$, urinary bladder at days $32.4{\sim}33.2\;(29{\sim}35)$, skeleton at days $34.7{\sim}35.9\;(34{\sim}39)$, and kidney at days $42.1{\sim}44.7\;(41{\sim}48)$, respectively. The the time of the first detection of the fetal structures were no statistically significant difference among bitches (p>0.05). These results indicate the evaluation of the time of first detection and ultrasonographic characteristics of the gestational structures might be useful for pregnancy diagnosis, estimating fetal age, embryonic resorption, fetal monster, abnormal fetal growth and fetal viability, respectively.

The development of Fetal Heart Rate monitoring system based on DSP processor (DSP 프로세서를 이용한 태아심음 및 자궁수축감시장치의 개발)

  • Jnag, D.P.;Kim, K.H.;Lee, Y.H.;Lee, Y.K.;Bak, M.I.;Lee, D.S.;Kim, S.I.
    • Proceedings of the KOSOMBE Conference
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    • v.1996 no.05
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    • pp.320-324
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    • 1996
  • Digital fetal monitoring system based on the personal computer combined with the digital signal processing board was implemented. The DSP board acquires and digitally processes ultrasound fetal Doppler signal for digital rectification, FIR filtering, autocorrelation function calculation, its peak detection and MEDIAN filtering. The personal computer interfaced with the DSP board is in charge of graphic display, hardcopy, data transmission and on-line analysis of fetal heart rate change including and variability. I used a recursive technique for autocorrelation function computation method and MEDIAN filter which can greatly reduce the amount of calculation and accuracy. I also implemented analysis algorithm of fetal heart rate change based on normal fetal sample data in order to exact diagnosis.

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Chorionic villus sampling

  • Shim, Soon-Sup
    • Journal of Genetic Medicine
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    • v.11 no.2
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    • pp.43-48
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    • 2014
  • Chorionic villus sampling has gained importance as a tool for early cytogenetic diagnosis with a shift toward first trimester screening. First trimester screening using nuchal translucency and biomarkers is effective for screening. Chorionic villus sampling generally is performed at 10-12 weeks by either the transcervical or transabdominal approach. There are two methods of analysis; the direct method and the culture method. While the direct method may prevent maternal cell contamination, the culture method may be more representative of the true fetal karyotype. There is a concern for mosaicism which occurs in approximately 1% of cases, and mosaic results require genetic counseling and follow-up amniocentesis or fetal blood sampling. In terms of complications, procedure-related pregnancy loss rates may be the same as those for amniocentesis when undertaken in experienced centers. When the procedure is performed after 9 weeks gestation, the risk of limb reduction is not greater than the risk in the general population. At present, chorionic villus sampling is the gold standard method for early fetal karyotyping; however, we anticipate that improvements in noninvasive prenatal testing methods, such as cell free fetal DNA testing, will reduce the need for invasive procedures in the near future.

Factors associated with Maternal-fetal Attachment of Expectant Mothers Whose Fetus Has a Prenatal Diagnosis of Congenital Heart Disease (선천성 심장병 태아를 임신한 임부의 모-태아 애착 및 관련 요인)

  • Im, Yu-Mi;Kim, Eun-Sook;Yoo, Il-Young
    • Child Health Nursing Research
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    • v.18 no.3
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    • pp.150-156
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    • 2012
  • Purpose: The main purposes of this study were to assess maternal-fetal attachment (MFA) of the expectant mothers of a fetus with a prenatal diagnosis of congenital heart disease (CHD) and to identify factors associated with MFA. Methods: The methodology was a cross sectional survey study using a self-administered questionnaire. Thirty pregnant women carrying a fetus with a prenatal diagnosis of CHD and 30 pregnant women with a normal fetus were enrolled in this study. The MFA Scale and PPS (The Prenatal Psychosocial Profile) were used to collect data. Data were analyzed using SPSS 20.0 Window version. Descriptive statistics, $X^2$-test and t-test were used to compare the two groups. The factors associated with MFA were identified by multiple regression analysis. Results: There was no significant difference between the two groups in MFA and social support from spouse was the only variable showing a significant difference. The model from the multiple regression analysis explained 33.8% of MFA for both groups. Conclusion: MFA of expectant mothers with a prenatal diagnosis of CHD and of mothers with a normal fetus were not significantly different. It is important that health care providers encourage expectant fathers to support the expectant mothers to increase MFA.

Prenatal ultrasonographic diagnosis of cleft lip with or without cleft palate; pitfalls and considerations

  • Kim, Dong Wook;Chung, Seung-Won;Jung, Hwi-Dong;Jung, Young-Soo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.24.1-24.5
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    • 2015
  • Ultrasonographic examination is widely used for screening of abnormal findings on prenatal screening. Cleft lip with or without cleft palate of the fetus can also be screened by using ultrasonography. Presence of abnormal findings of the fetal lip or palate can be detected by the imaging professionals. However, such findings may not be familiar to oral and maxillofacial surgeons. Oral and maxillofacial surgeons can use ultrasonographic imaging of fetal cleft lip with or without cleft palate to provide information regarding treatment protocols and outcomes to the parent. Therefore, surgeons should also be able to identify the abnormal details from the images, in order to setup proper treatment planning after the birth of the fetus. We report two cases of cleft lip with or without cleft palate that the official readings of prenatal ultrasonography were inconsistent with the actual facial structure identified after birth. Also, critical and practical points in fetal ultrasonographic diagnosis are to be discussed.