@article {768, title = {The utility of exome sequencing for fetal pleural effusions.}, journal = {Prenat Diagn}, volume = {40}, year = {2020}, month = {2020 04}, pages = {590-595}, abstract = {

OBJECTIVE: We sought to evaluate the performance of exome sequencing (ES) in determining an underlying genetic etiology for cases of fetal pleural effusions.

STUDY DESIGN: We examined a prospective cohort series of fetal pleural effusions visualized sonographically between 1 April 2016 and 31 August 2017. Fetal pleural effusions attributed to twin sharing, anemia, or structural anomalies were excluded, as were all cases with a genetic diagnosis established by karyotype or chromosomal microarray analysis. The remaining cases with pleural effusions of unclear etiology were offered ES. ES was performed by clinical sequencing and/or sequencing under the Baylor-Hopkins Center for Mendelian Genomics{\textquoteright} (BHCMG) research platform. All cases were evaluated for novel genes or phenotypic expansion of disease-causing genes.

RESULTS: ES was performed on six probands affected by pleural effusions. A pathogenic variant was identified in one case (16.7\%). Four additional cases had variants of uncertain significance (VUS) in candidate genes of pathological interest. Neither clinical nor candidate genes were evident in the final case.

CONCLUSION: ES should be considered in the evaluation of prenatally detected idiopathic pleural effusions when other diagnostic workup for a genetic etiology has failed.

}, issn = {1097-0223}, doi = {10.1002/pd.5650}, author = {Jelin, Angie C and Sobreira, Nara and Wohler, Elizabeth and Solomon, Benjamin and Sparks, Teresa and Sagaser, Katelynn G and Forster, Katherine R and Miller, Jena and Witmer, P Dane and Hamosh, Ada and Valle, David and Blakemore, Karin} } @article {669, title = {Genetic diagnosis in first or second trimester pregnancy loss using exome sequencing: a systematic review of human essential genes.}, journal = {J Assist Reprod Genet}, volume = {36}, year = {2019}, month = {2019 Aug}, pages = {1539-1548}, abstract = {

PURPOSE: Non-aneuploid recurrent pregnancy loss (RPL) affects approximately 100,000 pregnancies worldwide annually. Exome sequencing (ES) may help uncover the genetic etiology of RPL and, more generally, pregnancy loss as a whole. Previous studies have attempted to predict the genes that, when disrupted, may cause human embryonic lethality. However, predictions by these early studies rarely point to the same genes. Case reports of pathogenic variants identified in RPL cases offer another clue. We evaluated known genetic etiologies of RPL identified by ES.

METHODS: We gathered primary research articles from PubMed and Embase involving case reports of RPL reporting variants identified by ES. Two authors independently reviewed all articles for eligibility and extracted data based on predetermined criteria. Preliminary and amended analysis isolated 380 articles; 15 met all inclusion criteria.

RESULTS: These 15 articles described 74 families with 279 reported RPLs with 34 candidate pathogenic variants in 19 genes (NOP14, FOXP3, APAF1, CASP9, CHRNA1, NLRP5, MMP10, FGA, FLT1, EPAS1, IDO2, STIL, DYNC2H1, IFT122, PADI6, CAPS, MUSK, NLRP2, NLRP7) and 26 variants of unknown significance in 25 genes. These genes cluster in four essential pathways: (1) gene expression, (2) embryonic development, (3) mitosis and cell cycle progression, and (4) inflammation and immunity.

CONCLUSIONS: For future studies of RPL, we recommend trio-based ES in cases with normal parental karyotypes. In vitro fertilization with preimplantation genetic diagnosis can be pursued if causative variants are found. Utilization of other sequencing technologies in concert with ES should improve understanding of the causes of early embryonic lethality in humans.

}, issn = {1573-7330}, doi = {10.1007/s10815-019-01499-6}, author = {Robbins, Sarah M and Thimm, Matthew A and Valle, David and Jelin, Angie C} }