Serbest fetal DNA fraksiyonu plasental problemlere bağlı gebelik sonuçlarında değişir mi?

Year 2022, Volume: 5 Issue: 3, 176 - 180, 15.10.2022

Bertan Akar , Emre Köle , Canan Özcan , Merve Çakır Köle

https://doi.org/10.53446/actamednicomedia.1173411

Abstract

Amaç: Cff-DNA’nın non-invazif tanı uygulamaları dışında, bu biyobelirtecin preeklampsi, IUGR, preterm doğum gibi önemli obstetrik komplikasyonları belirlemede yerini araştırmak.
Yöntemler: Çalışmamız eylül 2019-mart 2020 tarihleri arasında, kliniğimize başvuran 10-24. Gebelik haftaları arasında kendi isteği, ileri anne yaşı olan (≥40) ve ikili testte artmış trizomi 13, 18 ve 21 riski nedeniyle serbest fetal DNA analizi (HarmonyTM Prenatal Test; Ariosa Diagnostics Inc., San Jose, Calif., USA) yapılan 131 hastalarda tek merkezli retrospektif çalışma olarak planlandı.
Bulgular: Çalışmamızda hastaların 10’ unda (%8,1) oligohidramnios, 10’ unda (%8,1) gestasyonel diyabet, 7’ sinde de (%8,6) preeklampsi gözlenmiştir. 2 hastada da (%1,2) dekolman plasenta izlenmiştir. 10-24. gebelik haftaları arası ölçülen hücre dışı fetal DNA fraksiyonlarının artmış düzeyleri IUGR ile sonuçlanan gebelikleri öngörmede anlamlı bulunmuştur (p< 0.01). Diğer gebelik sonuçları ( preeklampsi, GDM, preterm eylem, oligohidroamnios, dekolman plasenta ) ve hücre dışı fetal DNA fraksiyon düzeyleri ile anlamlı ilişki bulunamamıştır.
Sonuç: Cff-DNA’nın prenatal taramada bir dizi değerli uygulamaya sahiptir ancak gebelik komplikasyonlarını öngörmede cff-DNA’nın düzeyleri ile ilişkisi klinik uygulamada henüz yeri netleşmemiştir. Bu nedenle çalışmalar, cff-DNA’nın potansiyel öngörüsü ve tanısal uygulamalarını belirlemek için gebelikteki patolojik koşullar altındaki düzeylerinin belirlemesini amaçlamalıdır.

Keywords

cffDNA, gebelik, plasenta, gebelik sonuçları

DO THE LEVELS OF cffDNA FRACTION CHANGE IN PREGNANCIES WITH PLACENTAL PROBLEMS?

Abstract

Aim : To investigate the value of the cell free fetal DNA (cff-DNA) for determining the important obstetric complications such as preeclampsia, intrauterine growth retardation (IUGR) and, preterm labor other than prenatal screening of fetal aneuploidies.
Material and Methods : Our single center- retrospective study included 131 pregnant women in their 10-24th weeks of gestation, between the dates September 2019 and March 2020 who applied for cff-DNA analysis (HarmonyTM Prenatal Test; Ariosa Diagnostics Inc., San Jose, Calif., USA) with indications including advanced maternal age (≥40) and high risk for trisomy 13, 18 and 21 according to the results of the first trimester prenatal screening or solely on their own desire.
Results : Oligohydraamnios was observed in 10 (%8,1) patients, gestational diabetes in 10 patients (%8,1) , preeclampsia in 7 ( %8,6) patients and ablatio plasenta in 2 (%1,2) patients in this study. Increasing levels of the extracellular fetal DNA fractions in 10-24th gestational weeks showed statistically significant correlation for predicting the risk for IUGR (p< 0.01). There was not a statistically significant difference between the level of extracellular fetal DNA fractions and the other obstetric complications (preeclampsia, preterm labor, GDM, oligohydraamnios).
Conclusion : Although cff-DNA has many valuable implications as a novel biomarker for prenatal screening for special fetal aneuploidies, the association between the levels of cff-DNA and the risk of obstetric complications in clinical practice has not been clarified yet . Further studies should aim to investigate the cff-DNA levels in patients with pathological obstetric conditions in order to detect its potential predictive value and diagnostic implementation.

Keywords

cffDNA, pregnancy, placenta, pregnancy outcomes

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