Descripción general
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El oligohidramnios se define como un volumen anormalmente bajo de líquido amniótico. El líquido amniótico es crucial para el desarrollo y el crecimiento fetal, ya que protege al feto de traumatismos e infecciones y ayuda al desarrollo de los pulmones fetales. El líquido amniótico normal varía, en promedio puede alcanzar hasta 800-1000 ml. Un exceso de líquido amniótico se denomina polihidramnios, la disminución de líquido amniótico es oligohidramnios. Ocurre en aproximadamente el 11% de todos los embarazos. Las causas del oligohidramnios incluyen ruptura de membranas, bloqueo del tracto urinario fetal (agenesia renal, válvulas uretrales posteriores o enfermedad renal poliquística) que pueden tener antecedentes genéticos asociados con otras afecciones genéticas. La mortalidad es alta, especialmente si se diagnostica durante el primer trimestre, ya que puede aumentar el riesgo de fijación de la pared torácica e hipoplasia pulmonar.
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El panel de precisión de oligohidramnios de Igenomix se puede utilizar para realizar un diagnóstico diferencial directo y preciso de oligohidramnios y descubrir la genética subyacente a este signo clínico que, en última instancia, conduce a un mejor manejo y a lograr un bebé sano en casa. Proporciona un análisis completo de los genes involucrados en esta enfermedad utilizando secuenciación de próxima generación (NGS) para comprender completamente el espectro de genes relevantes involucrados.
Utilidad clínica
La utilidad clínica de este panel es:
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La confirmación genética y molecular para un diagnóstico clínico preciso de un paciente sintomático.
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Inicio precoz del tratamiento con un equipo multidisciplinario para la hospitalización y manejo obstétrico en caso de parto prematuro y que proporcione una hidratación adecuada.
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Evaluación de riesgo de familiares asintomáticos según el modo de herencia.
Genes y enfermedades
GENE |
OMIM DISEASES |
INHERITANCE* |
% GENE COVERAGE |
HGMD** |
ACE |
Renal Tubular |
AR |
88.42 |
40 of 44 |
AGT |
Essential Hypertension, |
AR,MU |
100 |
16 of 18 |
AGTR1 |
Essential Hypertension, |
AR,MU |
100 |
8 of 8 |
ALB |
Congenital Analbuminemia |
AR |
100 |
41 of 41 |
ALG8 |
Congenital Disorder Of |
AD,AR |
99.5 |
22 of 22 |
ALG9 |
Congenital Disorder Of |
AR |
99.99 |
6 of 6 |
ALX4 |
Craniosynostosis, Enlarged |
AD,AR |
99.94 |
25 of 25 |
AMER1 |
Osteopathia Striata With |
X,XD,G |
99.45 |
NA of NA |
ASCL1 |
Congenital Failure of |
AD |
97.86 |
1 of 4 |
ATRX |
Alpha-Thalassemia |
X,XR,XD,G |
98.5 |
NA of NA |
B9D1 |
Joubert Syndrome, |
AR |
90.23 |
11 of 11 |
B9D2 |
Meckel Syndrome |
AR |
84.81 |
4 of 5 |
BMPER |
Diaphanospondylodysostosis |
AR |
99.98 |
22 of 22 |
BNC2 |
Congenital Lower |
AD |
98.85 |
14 of 14 |
BRCA1 |
Fanconi Anemia |
AD,AR,MU |
98.97 |
2783 of 2894 |
BRCA2 |
Fanconi Anemia |
AD,AR,MU |
98.51 |
3343 of 3451 |
BRIP1 |
Fanconi Anemia |
AD,AR |
94.97 |
235 of 237 |
BUB1B |
Mosaic Variegated |
AD,AR |
99.84 |
30 of 31 |
C1QBP |
Combined Oxidative |
AR |
99.89 |
6 of 6 |
CC2D2A |
Coach Syndrome, |
AR |
99.43 |
98 of 100 |
CEP290 |
Bardet-Biedl Syndrome, |
AR |
96.47 |
293 of 327 |
CEP55 |
Anhydramnios, |
AR |
99.22 |
3 of 3 |
CERT1 |
Autosomal |
AD |
99.98 |
8 of 8 |
CHRM3 |
Absence of Abdominal |
AR |
99.8 |
4 of 4 |
CLTCL1 |
|
|
100 |
22 of 22 |
COG5 |
Congenital Disorder |
AR |
100 |
19 of 19 |
COQ2 |
Coenzyme Q10 Deficiency, |
AD,AR |
99.61 |
37 of 38 |
COQ7 |
Primary Coenzyme Q10 |
AR |
99.71 |
6 of 6 |
CPT2 |
Carnitine Palmitoyltransferase |
AD,AR |
99.99 |
116 of 116 |
CSPP1 |
Joubert Syndrome, |
AR |
98.32 |
29 of 30 |
DHPS |
Neurodevelopmental |
AR |
99.85 |
4 of 4 |
DOCK6 |
Adams-Oliver Syndrome |
AR |
98.06 |
37 of 37 |
DONSON |
Microcephaly-Micromelia |
AR |
98.14 |
26 of 27 |
EFEMP2 |
Autosomal Recessive |
AR |
99.99 |
17 of 17 |
ERCC4 |
Fanconi Anemia |
AR |
99.68 |
69 of 72 |
ERGIC1 |
Arthrogryposis Multiplex |
AR |
100 |
2 of 2 |
EXOSC9 |
Pontocerebellar Hypoplasia |
AR |
99.86 |
2 of 2 |
FANCA |
Fanconi Anemia |
AR |
95.17 |
497 of 502 |
FANCB |
Fanconi Anemia |
X,XR,G |
95.53 |
NA of NA |
FANCC |
Fanconi Anemia |
AR |
100 |
75 of 75 |
FANCD2 |
Fanconi Anemia |
AR |
100 |
62 of 63 |
FANCE |
Fanconi Anemia |
AR |
97 |
17 of 18 |
FANCF |
Fanconi Anemia |
AR |
99.31 |
17 of 18 |
FANCG |
Fanconi Anemia |
|
100 |
94 of 94 |
FANCI |
Fanconi Anemia |
AR |
100 |
53 of 54 |
FANCL |
Fanconi Anemia |
AR |
100 |
25 of 26 |
FANCM |
Fanconi Anemia, |
AR |
99.73 |
59 of 61 |
FARSB |
Rajab Interstitial Lung |
AR |
99.94 |
4 of 4 |
FBLN5 |
Autosomal Dominant |
AD,AR |
97.43 |
23 of 23 |
FBN1 |
Acromicric Dysplasia, |
AD |
100 |
2836 of 2845 |
FGF20 |
Bilateral Renal |
AR |
99.76 |
2 of 2 |
GATA6 |
Atrial Septal Defect, |
AD,AR |
84.19 |
66 of 84 |
GLI3 |
Greig Cephalopolysyndactyly |
AD,AR |
100 |
231 of 231 |
GMPPB |
Muscular |
AR |
99.95 |
53 of 53 |
GNPTAB |
Mucolipidosis II Alpha/Beta, |
AR |
100 |
279 of 280 |
GREB1L |
Bilateral Renal |
AD |
97.94 |
41 of 41 |
HBA1 |
Alpha-thalassemia, |
AD |
98.87 |
125 of 152 |
HBA2 |
Alpha-thalassemia, |
AD |
74.46 |
118 of 231 |
HNF1B |
Noninsulin-Dependent |
AD |
100 |
219 of 220 |
HSPA9 |
Sideroblastic Anemia, |
AD,AR |
99.72 |
14 of 14 |
HYMAI |
Transient Neonatal |
AD |
na |
na |
INVS |
Nephronophthisis, |
AR |
99.9 |
38 of 38 |
ITGA8 |
Bilateral Renal |
AR |
99.68 |
7 of 7 |
KIF14 |
Meckel Syndrome, |
AR |
99.84 |
18 of 18 |
LARS2 |
Hydrops, Lactic Acidosis, |
AR |
99.99 |
20 of 20 |
LHX1 |
17q12 Microdeletion |
|
100 |
6 of 6 |
LIFR |
Stuve-Wiedemann |
AR |
99.81 |
33 of 33 |
MAD2L2 |
Fanconi Anemia |
AR |
99.91 |
1 of 1 |
MBTPS2 |
Ichthyosis Follicularis, |
X,XR,G |
100 |
NA of NA |
MKS1 |
Bardet-Biedl Syndrome, |
AR |
99.98 |
49 of 49 |
MYH3 |
Arthrogryposis, Contractures, |
AD,AR |
100 |
46 of 47 |
NALCN |
Congenital Contractures |
AD,AR |
99.97 |
69 of 69 |
NEK8 |
Nephronophthisi, |
AR |
100 |
24 of 24 |
NEK9 |
Arthrogryposis, |
AR |
99.98 |
4 of 4 |
NPHP3 |
Meckel Syndrome, |
AR |
99.99 |
84 of 84 |
OSGEP |
Galloway-Mowat Syndrome |
AR |
99.17 |
19 of 19 |
PALB2 |
Fanconi Anemia |
AD,AR |
98.78 |
601 of 617 |
PBX1 |
Congenital Anomalies |
AD |
98 |
18 of 18 |
PDSS2 |
Coenzyme Q10 Deficiency, |
AR |
99.99 |
6 of 6 |
PGAP2 |
Hyperphosphatasia With |
AR |
99.99 |
11 of 11 |
PGAP3 |
Hyperphosphatasia With |
AR |
97 |
19 of 20 |
PHOX2B |
Congenital Failure of |
AD |
90.74 |
58 of 71 |
PIGL |
Zunich Neuroectodermal |
AR |
86 |
11 of 13 |
PIGO |
Hyperphosphatasia |
AR |
99.93 |
21 of 21 |
PIGV |
Hyperphosphatasia |
AR |
99.99 |
16 of 16 |
PIGW |
Hyperphosphatasia |
AR |
99.52 |
6 of 6 |
PIGY |
Hyperphosphatasia |
AR |
100 |
1 of 2 |
PKHD1 |
Autosomal Recessive |
AR |
99.97 |
582 of 585 |
PLAGL1 |
Paternal Uniparental |
|
95.56 |
2 of 2 |
POR |
Antley-Bixler Syndrome |
AD,AR |
99.98 |
67 of 68 |
PUF60 |
Verheij Syndrome, 8q24.3 |
AD |
100 |
30 of 30 |
RAD51 |
Fanconi Anemia Complementation |
AD |
99.98 |
16 of 16 |
RAD51C |
Fanconi Anemia |
AR |
100 |
130 of 130 |
REN |
Familial Juvenile |
AD,AR |
100 |
23 of 23 |
RET |
Congenital Failure of |
AD |
100 |
453 of 454 |
RFWD3 |
Fanconi Anemia |
AR |
99.99 |
2 of 2 |
RNU4ATAC |
Lowry-Wood Syndrome, |
AR |
na |
na |
RPGRIP1 |
Cone-Rod Dystrophy, |
AR |
99.33 |
146 of 159 |
RPGRIP1L |
Coach Syndrome, |
AR |
99.96 |
52 of 52 |
SEC24D |
Cole-Carpenter |
AR |
99.97 |
14 of 14 |
SLC25A24 |
Fontaine Progeroid |
AD |
99.59 |
2 of 2 |
SLX4 |
Fanconi Anemia |
AR |
99.92 |
76 of 76 |
TALDO1 |
Transaldolase Deficiency |
AR |
95 |
13 of 14 |
TBCK |
Infantile Hypotonia |
AR |
99.95 |
15 of 15 |
TCTN2 |
Joubert Syndrome, |
AR |
100 |
14 of 14 |
TCTN3 |
Joubert Syndrome, |
AR |
99.99 |
13 of 13 |
TMEM107 |
Meckel Syndrome, |
AR |
100 |
3 of 3 |
TMEM216 |
Meckel Syndrome, |
AR |
98.74 |
8 of 8 |
TMEM231 |
Meckel Syndrome, |
AR |
98.63 |
20 of 21 |
TMEM67 |
Bardet-Biedl Syndrome, |
AR |
96.93 |
177 of 179 |
TMEM70 |
Mitochondrial Complex V (ATP Synthase) |
AR |
100 |
22 of 24 |
TRIP4 |
Congenital Muscular |
AR |
99.92 |
3 of 3 |
UBE2A |
X-linked Syndromic Mental Retardation |
X,XR,G |
99.99 |
NA of NA |
UBE2T |
Fanconi Anemia |
AR |
100 |
4 of 4 |
WDPCP |
Bardet-Biedl |
AR |
99.3 |
8 of 8 |
WDR73 |
Galloway-Mowat Syndrome, |
AR |
95.71 |
14 of 14 |
WNT4 |
46,XX Sex Reversal With |
AD,AR |
100 |
8 of 8 |
XRCC2 |
Fanconi Anemia |
AR |
98.39 |
28 of 28 |
* Herencia: AD: Autosómico Dominante; AR: autosómico recesivo; X: ligado a X; XLR: recesivo vinculado a X; Mi: mitocondrial; Mu: multifactorial; G: herencia gonosomal; D: herencia digénica
** HGMD: número de mutaciones clínicamente relevantes según HGMD
Referencias
Dias, T., Sairam, S., & Kumarasiri, S. (2014). Ultrasound diagnosis of fetal renal abnormalities. Best practice & research. Clinical obstetrics & gynaecology, 28(3), 403–415. https://doi.org/10.1016/j.bpobgyn.2014.01.009
Gimpel, C., Avni, F. E., Bergmann, C., Cetiner, M., Habbig, S., Haffner, D., König, J., Konrad, M., Liebau, M. C., Pape, L., Rellensmann, G., Titieni, A., von Kaisenberg, C., Weber, S., Winyard, P., & Schaefer, F. (2018). Perinatal Diagnosis, Management, and Follow-up of Cystic Renal Diseases: A Clinical Practice Recommendation With Systematic Literature Reviews. JAMA pediatrics, 172(1), 74–86. https://doi.org/10.1001/jamapediatrics.2017.3938
Sahin, E., Madendag, Y., Tayyar, A., Sahin, M., Col Madendag, I., & Acmaz, G. et al. (2017). Perinatal outcomes in uncomplicated late preterm pregnancies with borderline oligohydramnios. The Journal Of Maternal-Fetal & Neonatal Medicine, 31(23), 3085-3088. doi: 10.1080/14767058.2017.1364722
Magann, E., Haas, D., Hill, J., Chauhan, S., Watson, E., & Learman, L. (2011). Oligohydramnios, Small for Gestational Age and Pregnancy Outcomes: An Analysis Using Precise Measures. Gynecologic And Obstetric Investigation, 72(4), 239-244. doi: 10.1159/000324570
Leung J. C. (2014). Inherited renal diseases. Current pediatric reviews, 10(2), 95–100. https://doi.org/10.2174/157339631002140513101755