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Prenatal diagnosis of mosaic trisomy 16 associated with congenital diaphragmatic hernia and elevated maternal serum alpha‐fetoprotein and human chorionic gonadotrophin
Author(s) -
Chen ChihPing,
Shih JinChung,
Chern SchuRern,
Lee ChenChi,
Wang Wayseen
Publication year - 2004
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.796
Subject(s) - trisomy , diaphragmatic hernia , amniocentesis , umbilical cord , prenatal diagnosis , medicine , fetus , amniotic fluid , aneuploidy , chorionic villi , obstetrics , pregnancy , biology , hernia , anatomy , chromosome , genetics , surgery , gene
Objectives To present the clinical, cytogenetic, and molecular findings of prenatally diagnosed mosaic trisomy 16. Case A 30‐year‐old gravida 2, para 1 woman was referred for amniocentesis because of a positive maternal serum screen result with elevated maternal serum alpha‐fetoprotein (MSAFP) and maternal serum free β‐human chorionic gonadotrophin (MSfreeβ‐hCG). Cytogenetic analysis of amniotic fluid at 21 weeks' gestation revealed mosaicism for trisomy 16, 47,XX,+16[3]/46,XX[15]. Ultrasonography demonstrated right diaphragmatic hernia and agenesis of left umbilical artery. The pregnancy was terminated subsequently. The karyotype of the cord blood was 46,XX. Cytogenetic analyses of the multiple sampled tissue specimens showed a karyotype of 47,XX,+16 in the placenta and 47,XX,+16/46,XX with various levels of trisomy 16 in the umbilical cord and skin. Molecular studies showed that the trisomy 16 in the placenta was likely to have resulted from a maternal meiosis II nondisjunction error. Partial dosage increase of an extra maternal allele was noted in the skin and umbilical cord. Conclusion Fetuses with mosaic trisomy 16 may be associated with congenital diaphragmatic hernia and elevated MSAFP and MShCG. Fetal blood sampling is of a limited value in confirming mosaic trisomy 16 ascertained through amniocentesis. Copyright © 2004 John Wiley & Sons, Ltd.