2013, Number 08
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Ginecol Obstet Mex 2013; 81 (08)
Current indications for invasive prenatal diagnosis. New proposals based on the experience of Instituto Nacional de Perinatología
Fernández-Hernández L, Domínguez-Castro M, Ibañez-Salvador JC,Grether-González P, Aguinaga-Ríos M
Language: Spanish
References: 15
Page: 454-460
PDF size: 518.20 Kb.
ABSTRACT
Background: Invasive prenatal diagnosis (IPD) allows identification
of fetal diseases, mainly aneuploidy. With the addition
of first-trimester prenatal screening and structural ultrasound,
IPD indications have changed.
Objective: To describe the current indications for IPD in
pregnant patients at INPer.
Methods: Descriptive and retrospective study. We reviewed
medical records of patients in which IPD was performed during
a period of 2.5 years.
Results: A total of 339 studies were performed: 81% by amniocentesis
(AC), 13% by chorionic villus sampling (CVS) and
6% by cordocentesis or somatocentesis.
The most common indications for AC were: advanced maternal
age (AMA) (43%), fetuses with multiple defects by ultrasonido
(23%) and presence of soft markers for aneuploidies
(9%). For CVS were: cystic hygroma (24%), Increased nuchal
translucency (NT) (24%), and AMA (18%).
When the indication was only AMA, 1.5% of fetus presented
aneuploidy. In women under 38 years and normal ultrasoud,
chromosomal abnormalities were not detected. The increased
NT in women ‹<35 years had a 21% detection and in patients
› 35 years it increased to 33%.
Conclusions: We observed that the group who had normal
translucencia nucal and AMA presented a low risk of chromosomal
abnormalities. In the presence of an increased NT,
33% of fetuses were affected, so that measuring TN is considered
the best non invasive PD tool. The average age with
cytogenetic abnormalities was above 38 years, so we suggest
to offer IPD in women above 38 years-old.
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