From Prenatal to Preimplantation Genetic Diagnosis of β-Thalassemia. Prevention Model in 8748 Cases: 40 Years of Single Center Experience

被引:24
作者
Monni, Giovanni [1 ]
Peddes, Cristina [1 ]
Iuculano, Ambra [1 ]
Ibba, Rosa Maria [1 ]
机构
[1] Microcitemico Pediat Hosp, Dept Prenatal & Preimplantat Genet Diag & Fetal T, I-09121 Cagliari, Italy
关键词
beta-thalassemia; prenatal diagnosis; genetic disease; chorionic villous sampling; amniocentesis; fetal blood sampling; pre-implantation genetic diagnosis; DNA; polymerase chain reaction; MATERNAL PLASMA; PRACTICE GUIDELINES; MULTIPLE PREGNANCY; FETAL DNA; ARRAY CGH; ALPHA; RISK; MUTATION; REARRANGEMENTS; HEMOGLOBIN;
D O I
10.3390/jcm7020035
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The incidence of -thalassemia in Sardinia is high and beta-39 is the most common mutation. The prevention campaign started in 1977 and was performed in a single center (Microcitemico Hospital, Cagliari, Sardinia, Italy). It was based on educational programs, population screening by hematological and molecular identification of the carriers. Prenatal and pre-implantation diagnosis was offered to couples at risk. 8564 fetal diagnosis procedures using different invasive approaches and analysis techniques were performed in the last 40 years. Trans-abdominal chorionic villous sampling was preferred due to lower complication risks and early diagnosis. Chorionic villous DNA was analyzed by PCR technique. 2138 fetuses affected by beta-thalassemia were diagnosed. Women opted for termination of the pregnancy (TOP) in 98.2% of these cases. Pre-implantation genetic diagnosis (PGD) was proposed to couples at risk to avoid TOP. A total of 184 PGD were performed. Initially, the procedure was exclusively offered to infertile couples, according to the law in force. The success rate of pregnancies increased from 11.1% to 30.8% when, crucial law changes were enacted, and PGD was offered to fertile women as well. Forty years of beta-thalassemia prevention programs in Sardinia have demonstrated the important decrease of this severe genetic disorder.
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页数:11
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