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Diagnostic prénatal non invasif : de la détermination du sexe fœtal à la détection d’aneuploïdie

Non-invasive prenatal diagnosis: from fetal sex determination to aneuploidy detection

  • Mise au Point / Update
  • Published:
Revue de médecine périnatale

Résumé

Le diagnostic prénatal permet de détecter des pathologies chez le fœtus in utero. Il requiert très souvent un prélèvement invasif, dont la principale complication est la survenue de fausses couches dans 0,5 à 4 % des cas. La découverte, à la fin des années 1990, d’ADN fœtal circulant libre dans le plasma maternel a permis le développement de techniques de diagnostic prénatal non invasif. La détermination du sexe fœtal et le génotypage RHD (rhésus (D)) font à présent partie des pratiques courantes et permettent de diminuer le nombre de prélèvements invasifs et le nombre de traitements inappropriés. Alors que le diagnostic non invasif des maladies monogéniques est encore à la phase de mise au point, les progrès technologiques récents, notamment concernant le séquençage haut débit, ont rendu possible le diagnostic de trisomie 21 à partir du sang maternel, dont la place reste encore à définir dans la prise en charge des patientes.

Abstract

Prenatal diagnosis aims at detecting in utero fetal diseases. It often requires an invasive fetal sampling, whose main complication is the occurrence of miscarriages in 0.5 to 4% of cases. The discovery of free fetal circulating DNA in maternal plasma in the late 1990s has enabled the development of techniques for non-invasive prenatal diagnosis. Fetal sex determination and RHD genotyping are now part of current practices and help to reduce the number of invasive samplings and inappropriate treatments. While the noninvasive diagnosis of monogenic diseases is still at the stage of development, recent technological advances — including next-generation sequencing—have made possible the diagnosis of trisomy 21 from maternal blood, whose contribution remains yet to be defined in patients’ management.

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Authors and Affiliations

  1. Service de cytogénétique constitutionnelle, centre de biologie et pathologie Est, hospices civils de Lyon, F-69677, Bron, France

    C. Schluth-Bolard, A. Labalme & D. Sanlaville

  2. Inserm U1028, CNRS UMR5292, université Claude-Bernard Lyon-I, équipe TIGER, F-69000, Lyon, France

    C. Schluth-Bolard & D. Sanlaville

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  1. C. Schluth-Bolard
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  2. A. Labalme
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  3. D. Sanlaville
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Correspondence to C. Schluth-Bolard.

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Schluth-Bolard, C., Labalme, A. & Sanlaville, D. Diagnostic prénatal non invasif : de la détermination du sexe fœtal à la détection d’aneuploïdie. Rev. med. perinat. 4, 74–79 (2012). https://doi.org/10.1007/s12611-012-0179-3

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  • DOI: https://doi.org/10.1007/s12611-012-0179-3

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