Ultrasound and genetic findings in a case series of fetuses presenting vertebral defects

Abstract Purpose This study aimed to summarize the ultrasound and genetic features in a case series of fetuses presenting vertebral defects, to provide useful information for prenatal counseling and prognostic evaluation. Methods Fetuses with vertebral anomalies by a second or third trimester ultras...

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Main Authors: Wanqin Xie, Lin Zhou, Ai Hu, Jing Chen, Jialun Pang, Hui Xi, Yingchun Luo, Jiancheng Hu, Shuting Yang, Xiaoyang Gao, Hanzhe Kuang, Wanglan Tang, Rui Liu, Silong Wang, Ying Peng
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Pregnancy and Childbirth
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Online Access:https://doi.org/10.1186/s12884-025-07920-6
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author Wanqin Xie
Lin Zhou
Ai Hu
Jing Chen
Jialun Pang
Hui Xi
Yingchun Luo
Jiancheng Hu
Shuting Yang
Xiaoyang Gao
Hanzhe Kuang
Wanglan Tang
Rui Liu
Silong Wang
Ying Peng
author_facet Wanqin Xie
Lin Zhou
Ai Hu
Jing Chen
Jialun Pang
Hui Xi
Yingchun Luo
Jiancheng Hu
Shuting Yang
Xiaoyang Gao
Hanzhe Kuang
Wanglan Tang
Rui Liu
Silong Wang
Ying Peng
author_sort Wanqin Xie
collection DOAJ
description Abstract Purpose This study aimed to summarize the ultrasound and genetic features in a case series of fetuses presenting vertebral defects, to provide useful information for prenatal counseling and prognostic evaluation. Methods Fetuses with vertebral anomalies by a second or third trimester ultrasound screening between January 2020 and April 2024 at a single center were included in the study. Chromosome microarray analysis (CMA) as a first-line diagnostic test was performed. Whole exome sequencing (WES) was further applied to the cases with negative CMA results. Results A total of 12 fetuses presenting vertebral defects were included. Isolated and non-isolated vertebral malformations were reported for eight (66.7%, 8/12) and four (33.3%, 4/12) fetuses, respectively. Congenital heart defects, microphthalmia, and duplicated kidney were among other structural anomalies associated with vertebral malformation in non-isolated cases. Of the 12 fetuses, five (41.7%) had positive results for prenatal diagnosis. CMA detected de novo 16p11.2 deletions (including the TBX6 gene) in three fetuses and a 7q36.1-q36.3 deletion in one fetus, respectively. WES followed by Sanger sequencing validation identified a novel frameshift duplication mutation TBX6 NM_004608.4: c.989_990dup p.(G331Pfs*168) in trans with the hypomorphic T-C-A haplotype (defined by SNPs rs2289292, rs3809624, and rs3809627) on the opposite allele in a fetus with a negative result for pathogenic copy number variants. There was no statistically significant difference in diagnostic yield between the isolated (25.0%, 2/8) and non-isolated (75%, 3/4) cases (Fisher exact test, P = 0.141). In all cases, six (50%, 6/12) had termination of pregnancy, three (25%, 3/12) had live birth with normal development at the latest follow-up, and three declined or were lost to follow-up. All live births were from cases with negative CMA and WES results. Conclusion CMA has a good performance for the diagnosis of fetuses presenting vertebral defects, and WES can further improve the diagnostic yield from the cases with negative CMA results. More studies are needed to reveal the etiologies and enhance the prenatal management of fetal vertebral defects.
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spelling doaj-art-e2592c8d3dea429ca8d859838188c3e32025-08-20T03:46:28ZengBMCBMC Pregnancy and Childbirth1471-23932025-08-012511810.1186/s12884-025-07920-6Ultrasound and genetic findings in a case series of fetuses presenting vertebral defectsWanqin Xie0Lin Zhou1Ai Hu2Jing Chen3Jialun Pang4Hui Xi5Yingchun Luo6Jiancheng Hu7Shuting Yang8Xiaoyang Gao9Hanzhe Kuang10Wanglan Tang11Rui Liu12Silong Wang13Ying Peng14Department of Medical Genetics, National Health Commission Key Laboratory of Birth Defects for Research and Prevention, Hunan Provincial Maternal and Child Health Care HospitalDepartment of Medical Genetics, National Health Commission Key Laboratory of Birth Defects for Research and Prevention, Hunan Provincial Maternal and Child Health Care HospitalDepartment of Medical Genetics, National Health Commission Key Laboratory of Birth Defects for Research and Prevention, Hunan Provincial Maternal and Child Health Care HospitalDepartment of Medical Genetics, National Health Commission Key Laboratory of Birth Defects for Research and Prevention, Hunan Provincial Maternal and Child Health Care HospitalDepartment of Medical Genetics, National Health Commission Key Laboratory of Birth Defects for Research and Prevention, Hunan Provincial Maternal and Child Health Care HospitalDepartment of Medical Genetics, National Health Commission Key Laboratory of Birth Defects for Research and Prevention, Hunan Provincial Maternal and Child Health Care HospitalDepartment of Medical Genetics, National Health Commission Key Laboratory of Birth Defects for Research and Prevention, Hunan Provincial Maternal and Child Health Care HospitalDepartment of Medical Genetics, National Health Commission Key Laboratory of Birth Defects for Research and Prevention, Hunan Provincial Maternal and Child Health Care HospitalDepartment of Medical Genetics, National Health Commission Key Laboratory of Birth Defects for Research and Prevention, Hunan Provincial Maternal and Child Health Care HospitalDepartment of Medical Genetics, National Health Commission Key Laboratory of Birth Defects for Research and Prevention, Hunan Provincial Maternal and Child Health Care HospitalDepartment of Medical Genetics, National Health Commission Key Laboratory of Birth Defects for Research and Prevention, Hunan Provincial Maternal and Child Health Care HospitalDepartment of Medical Genetics, National Health Commission Key Laboratory of Birth Defects for Research and Prevention, Hunan Provincial Maternal and Child Health Care HospitalDepartment of Medical Genetics, National Health Commission Key Laboratory of Birth Defects for Research and Prevention, Hunan Provincial Maternal and Child Health Care HospitalDepartment of Medical Genetics, National Health Commission Key Laboratory of Birth Defects for Research and Prevention, Hunan Provincial Maternal and Child Health Care HospitalDepartment of Medical Genetics, National Health Commission Key Laboratory of Birth Defects for Research and Prevention, Hunan Provincial Maternal and Child Health Care HospitalAbstract Purpose This study aimed to summarize the ultrasound and genetic features in a case series of fetuses presenting vertebral defects, to provide useful information for prenatal counseling and prognostic evaluation. Methods Fetuses with vertebral anomalies by a second or third trimester ultrasound screening between January 2020 and April 2024 at a single center were included in the study. Chromosome microarray analysis (CMA) as a first-line diagnostic test was performed. Whole exome sequencing (WES) was further applied to the cases with negative CMA results. Results A total of 12 fetuses presenting vertebral defects were included. Isolated and non-isolated vertebral malformations were reported for eight (66.7%, 8/12) and four (33.3%, 4/12) fetuses, respectively. Congenital heart defects, microphthalmia, and duplicated kidney were among other structural anomalies associated with vertebral malformation in non-isolated cases. Of the 12 fetuses, five (41.7%) had positive results for prenatal diagnosis. CMA detected de novo 16p11.2 deletions (including the TBX6 gene) in three fetuses and a 7q36.1-q36.3 deletion in one fetus, respectively. WES followed by Sanger sequencing validation identified a novel frameshift duplication mutation TBX6 NM_004608.4: c.989_990dup p.(G331Pfs*168) in trans with the hypomorphic T-C-A haplotype (defined by SNPs rs2289292, rs3809624, and rs3809627) on the opposite allele in a fetus with a negative result for pathogenic copy number variants. There was no statistically significant difference in diagnostic yield between the isolated (25.0%, 2/8) and non-isolated (75%, 3/4) cases (Fisher exact test, P = 0.141). In all cases, six (50%, 6/12) had termination of pregnancy, three (25%, 3/12) had live birth with normal development at the latest follow-up, and three declined or were lost to follow-up. All live births were from cases with negative CMA and WES results. Conclusion CMA has a good performance for the diagnosis of fetuses presenting vertebral defects, and WES can further improve the diagnostic yield from the cases with negative CMA results. More studies are needed to reveal the etiologies and enhance the prenatal management of fetal vertebral defects.https://doi.org/10.1186/s12884-025-07920-6Congenital scoliosis16p11.2 deletionTBX6Chromosome microarray analysisExome sequencing
spellingShingle Wanqin Xie
Lin Zhou
Ai Hu
Jing Chen
Jialun Pang
Hui Xi
Yingchun Luo
Jiancheng Hu
Shuting Yang
Xiaoyang Gao
Hanzhe Kuang
Wanglan Tang
Rui Liu
Silong Wang
Ying Peng
Ultrasound and genetic findings in a case series of fetuses presenting vertebral defects
BMC Pregnancy and Childbirth
Congenital scoliosis
16p11.2 deletion
TBX6
Chromosome microarray analysis
Exome sequencing
title Ultrasound and genetic findings in a case series of fetuses presenting vertebral defects
title_full Ultrasound and genetic findings in a case series of fetuses presenting vertebral defects
title_fullStr Ultrasound and genetic findings in a case series of fetuses presenting vertebral defects
title_full_unstemmed Ultrasound and genetic findings in a case series of fetuses presenting vertebral defects
title_short Ultrasound and genetic findings in a case series of fetuses presenting vertebral defects
title_sort ultrasound and genetic findings in a case series of fetuses presenting vertebral defects
topic Congenital scoliosis
16p11.2 deletion
TBX6
Chromosome microarray analysis
Exome sequencing
url https://doi.org/10.1186/s12884-025-07920-6
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