Korean J Obstet Gynecol.  2004 Mar;47(3):487-494.

Clinical Analysis of Prenatal Cytogenetic Diagnoses: Four-year Experience at Asan Medical Center

Affiliations
  • 1Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.
  • 2Department of Medical Genetics Laboratory, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.
  • 3Department of Clinical Pathology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.
  • 4Department of Pediatrics, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.

Abstract


OBJECTIVE
To review and evaluate a total of 2,372 cases of prenatal cytogenetic diagnoses at Asan Medical Center from 1999 to 2002.
METHODS
We reviewed the medical records of the patients in whom the procedure for prenatal cytogenetic diagnosis was performed. A total of 1780 cases of amniocentesis, 455 cases of cordocentesis, and 137 cases of chorionic villus sampling were analyzed. The cytogenetic results, indications for prenatal cytogenetic diagnoses, maternal ages, and the profiles of abnormal karyotypes were reviewed. We calculated the positive predictive value of each indication for abnormal fetal karyotypes and evaluated a factor that was the most sensitive marker for abnormal fetal karyotypes.
RESULTS
Among the 2,372 cases of prenatal cytogenetic diagnoses, abnormal karyotypes were identified in a total of 158 cases (6.7%). The most frequent indication for prenatal cytogenetic diagnosis was abnormal maternal serum screening (33.9%), followed by ultrasonographic abnormality (22.9%) and old age (20.0%). No significant difference was found between mean maternal age with and without abnormal fetal karyotypes after excluding balanced rearrangements and polymorphisms (31.9 +/- 5.3 vs. 32.1 +/- 4.5 years). Among the 92 cases of abnormal fetal karyotypes after excluding balanced rearrangements and polymorphisms, the most frequent indication for prenatal cytogenetic diagnosis was ultrasonographic abnormality (58.7%), followed by abnormal maternal serum screening (10.9%). The positive predictive value of ultrasonographic abnormality for abnormal fetal karyotype was 9.9%.
CONCLUSION
Among the several indications for prenatal cytogenetic diagnosis, ultrasonographic abnormality could be the most predictive marker for abnormal fetal karyotypes.

Keyword

Prenatal cytogenetic diagnosis; Amniocentesis; Cordocentesis; Chorionic villus sampling (CVS)

MeSH Terms

Abnormal Karyotype
Amniocentesis
Chorionic Villi Sampling
Chungcheongnam-do*
Cordocentesis
Cytogenetics*
Diagnosis*
Female
Humans
Karyotype
Mass Screening
Maternal Age
Medical Records
Pregnancy
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