Advanced genomic testing may aid in counseling of isolated agenesis of the corpus callosum on prenatal ultrasound

Prenat Diagn. 2017 Dec;37(12):1191-1197. doi: 10.1002/pd.5158. Epub 2017 Dec 3.

Abstract

Objective: Isolated agenesis of the corpus callosum on fetal ultrasound has a varied prognosis. Microarray and exome sequencing (ES) might aid in prenatal counseling.

Method: This study includes 25 fetuses with apparently isolated complete corpus callosum (cACC) on ultrasound. All cases were offered single nucleotide polymorphism array. Complementary ES was offered postnatally in selected cases. Clinical physical and neurodevelopmental follow-up was collected.

Results: Eighteen cases opted for single nucleotide polymorphism array testing, which detected a causal anomaly in 2/18 (11.1%; 95% CI 2.0%-31%). Among ongoing pregnancies without a causal anomaly on microarray, 30% (95% CI 8.5%-60%) showed intellectual disability. Postnatal magnetic resonance imaging and physical examination often (64%; 95% CI 38%-85%, and 64%; 95% CI 38%-85%, respectively) revealed additional physical anomalies in cases without a causal anomaly on microarray. Two cases appeared truly isolated after birth. Postnatal sequencing in 4 of 16 cases without a causal anomaly on microarray but with intellectual disability and/or additional postnatal physical anomalies revealed 2 single-gene disorders. Therefore, the estimated diagnostic yield of ES in chromosomally normal cACC fetuses is between 2/4 (50%; 95% CI 11%-89%) and 2/16 (13.3%; 95% CI 2.4%-36%).

Conclusion: In accordance with current guidelines, we conclude that microarray should be offered in case of isolated cACC on ultrasound. ES is likely to be informative for prenatal counseling and should be offered if microarray is normal.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Agenesis of Corpus Callosum / diagnostic imaging
  • Agenesis of Corpus Callosum / genetics*
  • Brain Diseases / diagnostic imaging
  • Cohort Studies
  • Female
  • Genetic Counseling
  • Genetic Testing*
  • Humans
  • Lateral Ventricles / abnormalities
  • Lateral Ventricles / diagnostic imaging
  • Magnetic Resonance Imaging
  • Oligonucleotide Array Sequence Analysis
  • Polymorphism, Single Nucleotide
  • Pregnancy
  • Sequence Analysis, DNA
  • Ultrasonography, Prenatal

Supplementary concepts

  • Colpocephaly