Prenatal BoBsTM in the cytogenetic analysis of products of spontaneous miscarriage

Abstract

Background. Fifty percent of spontaneous miscarriages (SMs) are attributed to chromosomal abnormalities. Cytogenetic analysis is an important tool for patient counselling and assessment of the risk of recurrence in future pregnancies. Conventional karyotyping has been the gold standard for chromosomal investigation of products of conception (POC), but it has limitations due to sample maceration, culture failure and maternal cell contamination. Molecular cytogenetic approaches have therefore been developed and found valuable in the cytogenetic investigation of these samples. The Prenatal BoBs^TM and KaryoLite BoBs^TM, based on the newly developed BACs-on-Beads^TM technology, have been described as reliable tests for rapid detection of aneuploidies in prenatal and POC samples, respectively.

Objective. To describe our clinical experience of routine screening of POC samples with Prenatal BoBs^TM, the test used by our laboratory in France.

Methods. Seventeen samples collected at the University Hospital of Sidi Bel Abbès (Western Algeria) and a further 60 from the University Hospital of Clermont-Ferrand (France) were analysed (19 chorionic villi from products of curettage, 12 placentas, 9 amniotic cells and 37 biopsy specimens). All were screened for the frequent aneuploidies (chromosomes 13, 18, 21, X and Y) in addition to nine microdeletion/microduplication syndrome regions by Prenatal BoBs^TM. Standard karyotyping was performed on 51 samples, but failed in 38 cases.

Results. Prenatal BoBs^TM identified one trisomy 21 and one deletion of 17p13.3. Furthermore, it provided a conclusive result in cases of culture failure (n=38) and in samples with macerated tissue (n=19). The overall failure rate was 11.4%.

Conclusions. Prenatal BoBs^TM is a promising technology that represents a fast, sensitive and robust alternative to routine screening for chromosomal abnormality in products of SM. Furthermore, it overcomes the limitations of conventional karyotyping and current molecular cytogenetic techniques.