Document Detail


Outcomes of spontaneous and assisted pregnancies in Turner syndrome: the U.S. National Institutes of Health experience.
MedLine Citation:
PMID:  21496813     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess fetal and maternal outcomes of pregnancies in women with Turner syndrome (TS).
DESIGN: Retrospective case series.
SETTING: Clinical research center.
PATIENT(S): 276 adults with cytogenetically proven TS participating in an intramural natural history protocol.
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): Menstrual and obstetric histories, 50-cell karyotypes, and cardiovascular evaluation including aortic diameter measurements.
RESULT(S): Our cohort included five women with spontaneous pregnancies and five with pregnancies using assisted reproduction (ART). All five women with spontaneous pregnancies had spontaneous puberty, despite 45,X in ≥90% of their 50-cell karyotype. Participants had a total of 13 pregnancies and 14 live births. One child had cerebral palsy; the others were chromosomally and developmentally normal. Delivery was by cesarean section in four out of seven spontaneous and six out of six ART-related pregnancies. One mother experienced preeclampsia in an ART-related twin pregnancy that required a preterm delivery; she has marked but stable aortic dilation years later.
CONCLUSION(S): Approximately 2% of our study cohort experienced spontaneous pregnancies despite high-grade X monosomy, and a similar number achieved pregnancy via oocyte donation and ART. The potential for life-threatening cardiovascular complications warrants comprehensive screening before conception or single-embryo transfer, and caution regarding unintentional pregnancies for TS women.
Authors:
Tracy N Hadnott; Harley N Gould; Ahmed M Gharib; Carolyn A Bondy
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Intramural; Research Support, Non-U.S. Gov't     Date:  2011-04-15
Journal Detail:
Title:  Fertility and sterility     Volume:  95     ISSN:  1556-5653     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-23     Completed Date:  2011-07-28     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2251-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2011. Published by Elsevier Inc.
Affiliation:
Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892-1103, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Analysis of Variance
Cerebral Palsy / genetics
Chromosomes, Human, X
Female
Fertility* / genetics
Humans
Karyotyping
Live Birth
Middle Aged
Monosomy
National Institutes of Health (U.S.)
Pregnancy
Pregnancy Complications, Cardiovascular / genetics
Pregnancy Rate
Puberty
Reproductive Techniques, Assisted* / adverse effects
Retrospective Studies
Risk Assessment
Risk Factors
Turner Syndrome / complications,  genetics,  physiopathology*
United States
Young Adult
Grant Support
ID/Acronym/Agency:
Z01 HD000628-18/HD/NICHD NIH HHS; //Howard Hughes Medical Institute
Comments/Corrections

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