Test Catalog

Test ID: PADF    
Prenatal Aneuploidy Detection, FISH

Useful For Suggests clinical disorders or settings where the test may be helpful

Screening for chromosomal aneuploidies of chromosomes 13, 18, 21, X, and Y in prenatal specimens

Testing Algorithm Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

This test includes a charge for application of the first probe set (2 FISH probes) and professional interpretation of results.

 

Additional charges will be incurred for all reflex probes performed. Analysis charges will be incurred based on the number of cells analyzed per probe set. If no cells are available for analysis, no analysis charges will be incurred.

 

The following algorithms are available in Special Instructions:

-High-Risk Pregnancy Based on Abnormal Fetal Malformations: Laboratory Testing Algorithm

-Prenatal Aneuploidy Screening and Diagnostic Testing Options

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Approximately half of clinically recognizable spontaneous abortions have a major chromosomal anomaly.

 

Up to 95% of chromosomal abnormalities diagnosed prenatally involve aneuploidy (gain or loss of whole chromosome) of chromosomes 13, 18, 21, X, and Y.

 

In liveborn infants, about 8/1,000 have a major chromosome anomaly, of which 6.5/1,000 involve aneuploidy of the 5 chromosomes analyzed by this test. Therefore, aneuploidy of chromosomes 13, 18, 21, X, and Y accounts for 81% to 95% of major chromosome anomalies in liveborn infants.

 

Techniques to detect aneuploidy include standard chromosome analysis and FISH. Standard chromosome analysis from amniotic fluid cells or chorionic villi requires 5 to 9 days for culture, harvest, and analysis. FISH, which uses DNA probes and can be performed on cultured and uncultured cells, can rapidly detect aneuploidy of 13, 18, 21, X, and Y in uncultured amniotic fluid cells or chorionic villi. FISH-based analysis may be helpful in medically urgent evaluations of newborn infants suspected to have aneuploidy of any of these chromosomes.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

An interpretive report will be provided.

Interpretation Provides information to assist in interpretation of the test results

An interpretive report will be provided.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

The use of these probes has been approved by the Food and Drug Administration as a stand-alone test. However, we recommend that complete chromosome analysis (CHRAF / Chromosome Analysis, Amniotic Fluid or CHRCV / Chromosome Analysis, Chorionic Villus Sampling) or chromosomal microarray (CMAP / Chromosomal Microarray, Prenatal, Amniotic Fluid/Chorionic Villus Sampling) be performed in conjunction with this FISH test. In cases where the FISH analysis is normal, a chromosome analysis or chromosomal microarray allows for the potential identification of more complex abnormalities and the less common numeric abnormalities of other chromosomes. In cases where the FISH study is abnormal, chromosome analysis can determine whether the abnormality is due to aneuploidy or a complex structural abnormality, allowing for recurrence risk information for the family.

 

Interfering factors:

-Inadequate amount of specimen may not permit adequate analysis

-Exposure of the specimen to temperature extremes (freezing or greater than 30 degrees C) may kill cells and interfere with attempts to culture cells

-Improper packaging may result in broken, leaky, and contaminated specimens during transport

-Transport time should not exceed 2 days

-Contamination by maternal cells may interfere with attempts to culture cells and may cause interpretive problems

Clinical Reference Recommendations for in-depth reading of a clinical nature

1. American College of Obstetricians and Gynecologists. (2007). ACOG Practice Bulletin No. 88, December 2007. Invasive prenatal testing for aneuploidy. Obstet Gynecol 110:1459-1467

2. Ward BE, Gersen SL, Carelli MP, et al: Rapid prenatal diagnosis of chromosomal aneuploidies by fluorescence in situ hybridization: Clinical experience with 4,500 specimens. Am J Hum Genet 1993;52:854-865

3. Sheets KB, Crissman BG, Feist CD, et al: Practice guidelines for communicating a prenatal or postnatal diagnosis of Down syndrome: recommendations of the national society of genetic counselors. J Genet Couns 2011;20:432-444

Special Instructions Library of PDFs including pertinent information and forms related to the test