The role of DNA microarrays in the evaluation of fetal death

Prenat Diagn. 2012 Apr;32(4):371-5. doi: 10.1002/pd.3825.

Abstract

Fetal death occurs in 15% of clinically recognized pregnancies. Cytogenetic abnormalities are present in 50% of spontaneous abortions (fetal deaths < 20 weeks) whereas the rate is 6% to 13% for stillbirths (fetal deaths ≥ 20 weeks). Microarray has been demonstrated to increase the diagnosis of genetic abnormalities by providing coverage of the entire genome at a higher density, detecting as small as 50 to 100 kb deletions or duplications, known as copy number changes. Microarray is particularly suited for evaluation of fetal death because DNA can still be analyzed in macerated fetuses and nonviable tissue, two situations where culturing and karyotyping is known to have low yield. Microarray has already proven successful in providing additional genetic information beyond karyotype in spontaneous abortion. The few studies on the use of microarray in stillbirth evaluation have been promising, demonstrating an increase in the diagnosis of clinically relevant genetic abnormalities when compared with karyotype. As the cost and technology improve, microarray may ultimately become the first line screen for genetic abnormalities in stillbirth. The accurate diagnosis of a genetic abnormality as the cause for fetal death may provide closure for families, prevent unnecessary treatments, and enable clinicians to more accurately counsel and manage subsequent pregnancies.

MeSH terms

  • Abnormal Karyotype
  • Abortion, Spontaneous / diagnosis
  • Abortion, Spontaneous / genetics
  • Adult
  • Chromosome Aberrations / embryology*
  • Chromosome Disorders / diagnosis*
  • Chromosome Disorders / genetics
  • Cost-Benefit Analysis
  • Female
  • Fetal Death / genetics*
  • Gene Expression Profiling
  • Genetic Diseases, Inborn / diagnosis*
  • Genetic Diseases, Inborn / genetics
  • Humans
  • Male
  • Oligonucleotide Array Sequence Analysis / economics
  • Oligonucleotide Array Sequence Analysis / methods*
  • Pregnancy
  • Stillbirth / genetics*