SCIENTIFIC BACKGROUND

ACAD9, ALG1, ALG12, ALG8, ARSB, ASAH1, BRAF, CBL, CCBE1, CEP55, CFH, CHD7, CTSA, DHCR24,
DHCR7, DMPK, EBP, FAT4, FGFR3, FH, FLT4, FOXC2, FOXP3, GAA, GALNS, GBA, GBE1, GLA, GLB1, GLE1,
GLUL, GNPTAB, GUSB, HADHA, HADHB, HBA1, HBA2, HNF1B, HRAS, IDUA, KLF1, KLHL40, KRAS, LBR,
LIPA, LZTR1, MAP2K1, MAP2K2, MKKS, MRAS, MVK, MYH3, MYRF, NEU1, NEXN, NF1, NPC1, NPC2,
NRAS, PEX1, PEX10, PEX12, PEX13, PEX14, PEX16, PEX19, PEX2, PEX26, PEX3, PEX5, PEX6, PEX7,
PIEZO1, PKLR, PMM2, PPP1CB, PTPN11, RAF1, RASA2, RIT1, RPL11, RRAS, SF3B4, SHOC2, SLC17A5,
SLC22A5, SMPD1, SOS1, SOS2, SPRED1, STAT3, SUMF1, SUZ12, TALDO1, TAZ, UROS, WAC, ZEB2

Scientific background

Hydrops fetalis is observed in around 1 in 1,700 to 1 in 3,000 pregnancies, with non-immunological hydrops (NIHF) present in over 90%. It is defined as an accumulation of fluid in at least two fetal compartments: subcutaneous (>5mm), pericardial, pleural and abdominal (ascites).

 

In addition to exogenous causes, it can be caused by over 150 mostly rare genetic diseases and genetic clarification should be carried out accordingly. This is usually done by diagnostic puncture and includes a chromosome analysis and/or a chromosomal microarray and, if inconspicuous, a molecular genetic test, which in turn should include a Noonan syndrome or RASopathy panel. The most common chromosomal disorder is Ullrich-Turner syndrome (45,X); the most common monogenic cause is Noonan syndrome. Furthermore, numerous metabolic disorders (probably >15%), especially lysosomal storage disorders, more frequent (alpha-thalassemia) and rare anemias, skeletal dysplasias, muscular, urogenital and cardiovascular diseases are possible causes. Even with extensive genetic testing, the cause of around 15 to 25% of NIHF remains unexplained.

 

The difficulty in the prenatal setting is that the phenotype is often completely unspecific and therefore does not provide any additional information when evaluating large panels or even an exome analysis.

GENES

ACAD9, ALG1, ALG12, ALG8, ARSB, ASAH1, BRAF, CBL, CCBE1, CEP55, CFH, CHD7, CTSA, DHCR24, DHCR7, DMPK, EBP, FAT4, FGFR3, FH, FLT4, FOXC2, FOXP3, GAA, GALNS, GBA, GBE1, GLA, GLB1, GLE1, GLUL, GNPTAB, GUSB, HADHA, HADHB, HBA1, HBA2, HNF1B, HRAS, IDUA, KLF1, KLHL40, KRAS, LBR, LIPA, LZTR1, MAP2K1, MAP2K2, MKKS, MRAS, MVK, MYH3, MYRF, NEU1, NEXN, NF1, NPC1, NPC2, NRAS, PEX1, PEX10, PEX12, PEX13, PEX14, PEX16, PEX19, PEX2, PEX26, PEX3, PEX5, PEX6, PEX7, PIEZO1, PKLR, PMM2, PPP1CB, PTPN11, RAF1, RASA2, RIT1, RPL11, RRAS, SF3B4, SHOC2, SLC17A5, SLC22A5, SMPD1, SOS1, SOS2, SPRED1, STAT3, SUMF1, SUZ12, TALDO1, TAZ, UROS, WAC, ZEB2
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