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Obstet Gynecol Sci > Volume 53(6); 2010 > Article
Korean Journal of Obstetrics & Gynecology 2010;53(6):489-496.
DOI: https://doi.org/10.5468/kjog.2010.53.6.489    Published online June 1, 2010.
Prenatal detection of skeletal dysplasia using ultrasound and molecular diagnosis.
Jung Myung Kim, Na Yeon Kim, Ji Yun Kim, Si Yeon You, Kwan Young Oh, Won Il Park, Kyung A Lee, Young Ju Kim, Sun Hee Chun, Mi Hye Park
1Department of Obstetrics and Gynecology, Ewha Womans University School of Medicine, Seoul, Korea. ewhapmh@ewha.ac.kr
2Department of Obstetrics and Gynecology, Eulji University College of Medicine, Daejeon, Korea.
Abstract
OBJECTIVE
To determine the accuracy and usefulness of prenatal ultrasonographic and molecular genetic diagnosis in detection of skeletal dysplasia. METHODS: This study was based upon data of the 17 cases of skeletal dysplasia diagnosed by prenatal ultrasound and 7 cases by molecular diagnosis performed among the 17 cases and the 2 cases who has familial skeletal dysplasia by molecular diagnosis during the first trimester at Ewha and Eulji University from March 1998 to August 2005. A final diagnosis was sought on the basis of radiographic studies, molecular testing, or both. RESULTS: The mean gestational age at diagnosis was 24.9 weeks (range, 17 to 35 weeks). Nine cases were diagnosed before 24 weeks. A final diagnosis was obtained in 16 cases (94.1%). There was 1 false-positive diagnosis. The antenatal diagnosis was correct in 14 cases (82.4%). The 8 cases were prenatally confirmed and 1 case was postpartum confirmed using molecular genetic testing and accurate antenatal diagnosis and prediction was done. We were able to rule out skeletal dysplasia through chorionic villus sampling during the first trimester in the 2 cases with the family history with skeletal dysplasia. CONCLUSION: Prenatal diagnosis of skeletal dysplasia can be a considerable diagnostic challenge. However, skeletal dysplasia is correctly diagnosed on the basis of prenatal meticulous ultrasound and antenatal prediction of lethality was highly accurate. Using prenatal molecular diagnosis, skeletal dysplasia can be diagnosed at first trimester of pregnancy and nonlethal skeletal dysplasia can be confirmed when prenatal ultrasound was nonspecific.
Key Words: Skeletal dysplasia, Prenatal ultrasound, Prenatal molecular diagnosis


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