Korean J Obstet Gynecol.  2010 Jun;53(6):489-496. 10.5468/kjog.2010.53.6.489.

Prenatal detection of skeletal dysplasia using ultrasound and molecular diagnosis

Affiliations
  • 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.

Keyword

Skeletal dysplasia; Prenatal ultrasound; Prenatal molecular diagnosis
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