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Prenatal Diagnosis: Microarray Analysis Bests Karyotyping

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Microarray Should Replace Karyotyping Only in Certain Cases

These findings support the use of microarray analysis instead of conventional karyotyping when fetal anomalies have been detected on ultrasound, said Dr. Lorraine Dugoff.

However, it is not yet established whether microarray testing is warranted in cases of advanced maternal age or when Down syndrome is suspected, because the significance of some chromosomal abnormalities remains uncertain. "In such cases ... it is possible that the counseling conundrum may outweigh the value of incremental information provided by the microarray analysis," she said.

"In addition, the increased cost associated with microarray – including the cost of parental studies in some cases – as compared with the cost of conventional karyotyping may be significantly out of proportion to the information gained in these lower-yield cases."

Dr. Dugoff is in the department of obstetrics and gynecology at the University of Pennsylvania, Philadelphia. She reported a pending research award from PerkinElmer for the study of preeclampsia. These remarks were taken from her editorial accompanying Dr. Wapner’s report (N. Engl. J. Med. 2012 Dec. 6 [doi:10.1056/NEJMe1212303]).


 

FROM THE NEW ENGLAND JOURNAL OF MEDICINE

They added that they are following the offspring from the pregnancies in which copy-number variants were discovered, to establish what, if any, phenotypes develop. They are particularly interested in linking specific chromosomal abnormalities with later diagnoses of developmental delay.

This study was supported by the National Institute of Child Health and Human Development. Agilent Technologies and Affymetrix donated the microarrays and reagents used in the study, and Integrated Genetics was reimbursed for the costs of handling samples and managing cytogenetic data. Dr. Wapner reported no potential financial conflicts of interest, and his associates reported numerous ties to industry sources.

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