Browsing by Author "Rybak-Krzyszkowska, Magda"
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- Implementation of Exome Sequencing in Prenatal Diagnosis and Impact on Genetic Counseling: The Polish ExperiencePublication . Kucińska-Chahwan, Anna; Geremek, Maciej; Roszkowski, Tomasz; Bijok, Julia; Massalska, Diana; Ciebiera, Michał; Correia, Hildeberto; Pereira-Caetano, Iris; Barreta, Ana; Obersztyn, Ewa; Kutkowska-Kaźmierczak, Anna; Własienko, Paweł; Krajewska-Walasek, Małgorzata; Węgrzyn, Piotr; Dudarewicz, Lech; Krzeszowski, Waldemar; Rybak-Krzyszkowska, Magda; Nowakowska, BeataBackground: Despite advances in routine prenatal cytogenetic testing, most anomalous fetuses remain without a genetic diagnosis. Exome sequencing (ES) is a molecular technique that identifies sequence variants across protein-coding regions and is now increasingly used in clinical practice. Fetal phenotypes differ from postnatal and, therefore, prenatal ES interpretation requires a large amount of data deriving from prenatal testing. The aim of our study was to present initial results of the implementation of ES to prenatal diagnosis in Polish patients and to discuss its possible clinical impact on genetic counseling. Methods: In this study we performed a retrospective review of all fetal samples referred to our laboratory for ES from cooperating centers between January 2017 and June 2021. Results: During the study period 122 fetuses were subjected to ES at our institution. There were 52 abnormal ES results: 31 in the group of fetuses with a single organ system anomaly and 21 in the group of fetuses with multisystem anomalies. The difference between groups was not statistically significant. There were 57 different pathogenic or likely pathogenic variants reported in 33 different genes. The most common were missense variants. In 17 cases the molecular diagnosis had an actual clinical impact on subsequent pregnancies or other family members. Conclusions: Exome sequencing increases the detection rate in fetuses with structural anomalies and improves genetic counseling for both the affected couple and their relatives.
- Is Nuchal Translucency of 3.0-3.4 mm an Indication for cfDNA Testing or Microarray? - A Multicenter Retrospective Clinical Cohort StudyPublication . Rybak-Krzyszkowska, Magda; Madetko-Talowska, Anna; Szewczyk, Katarzyna; Bik-Multanowski, Mirosław; Sakowicz, Agata; Stejskal, David; Trková, Marie; Smetanová, Dagmar; Serafim, Sílvia; Correia, Hildeberto; Nevado, Julian; Angeles Mori, Maria; Mansilla, Elena; Rutkowska, Lena; Kucińska, Agata; Gach, Agnieszka; Huras, Hubert; Kołak, Magdalena; Srebniak, Malgorzata IlonaIntroduction: This study aimed to evaluate the occurrence of clinically relevant (sub)microscopic chromosomal aberrations in fetuses with the nuchal translucency (NT) range from 3.0 to 3.4 mm, which would be potentially missed by cfDNA testing. Methods: A retrospective data analysis of 271 fetuses with NT between 3.0 and 3.4 mm and increased first trimester combined test (CT) risk in five cohorts of pregnant women referred for invasive testing and chromosomal microarray was performed. Results: A chromosomal aberration was identified in 18.8% fetuses (1:5; 51/271). In 15% (41/271) of cases, trisomy 21, 18, or 13 were found. In 0.7% (2/271) of cases, sex chromosome aneuploidy was found. In 1.1% (3/271) of cases, CNV >10 Mb was detected, which would potentially also be detected by genome-wide cfDNA testing. The residual risk for missing a submicroscopic chromosome aberration in the presented cohorts is 1.8% (1:54; 5/271). Conclusion: Our results indicate that a significant number of fetuses with increased CT risk and presenting NT of 3.0-3.4 mm carry a clinically relevant chromosomal abnormality other than common trisomy. Invasive testing should be offered, and counseling on NIPT should include the test limitations that may result in NIPT false-negative results in a substantial percentage of fetuses.