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A comparison of molecular and cytogenetic techniques for the diagnosis of pregnancy loss.
MedLine Citation:
PMID:  21102343     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
PURPOSE: To evaluate the sensitivity, specificity, advantages, and limitations of multiplex ligation-dependent probe amplification compared with conventional karyotype analysis in the investigation of contributing factors to recurrent pregnancy loss.
METHOD: A cohort of 284 patients underwent side-by-side analysis of products of conception by both conventional karyotyping and multiplex ligation-dependent probe amplification with direct comparison of results.
RESULTS: Multiplex ligation-dependent probe amplification was shown to enable a diagnosis for an additional 47 (16.5%) patients compared with conventional karyotype analysis. However, this advantage was offset by some disadvantages of the method, including a high false-positive rate (8/104; 7.7%), as demonstrated by single-arm probe abnormalities of uncertain clinical significance, as well as the inability to characterize structural rearrangements, such as Robertsonian translocations, which comprised 2.46% of samples (99% confidence interval = 0.09-4.83), and ploidy changes. The calculated performance characteristics of multiplex ligation-dependent probe amplification in this cohort yielded a sensitivity of 86.9% and specificity of 92.4%.
CONCLUSIONS: The advantages of now widely accepted molecular methodologies, such as lower failure rates, faster turnaround times, and lower cost, must be complemented by adequate counseling, family follow-up, and specific diagnostic reporting practices. It is particularly important to specifically address the important limitations of the methodology, including the inability to characterize balanced structural rearrangements and ploidy changes, especially if multiplex ligation-dependent probe amplification is to be performed alone.
Authors:
Melody C Caramins; Toni Saville; Rebecca Shakeshaft; Glenda L Mullan; Briar Miller; Moh-Ying Yip; Michael F Buckley
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Genetics in medicine : official journal of the American College of Medical Genetics     Volume:  13     ISSN:  1530-0366     ISO Abbreviation:  Genet. Med.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9815831     Medline TA:  Genet Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  46-51     Citation Subset:  IM    
Affiliation:
Department of Haematology and Genetics, South Eastern Area Laboratory Services, The Prince of Wales and Sydney Children's hospitals, Randwick, Sydney, Australia. melody.caramins@sesiahs.health.nsw.gov.au
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