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Outcomes of Spontaneous and Assisted Pregnancies in Turner Syndrome: The NIH Experience

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Outcomes of Spontaneous and Assisted Pregnancies in Turner Syndrome: The NIH Experience

Auteurs : Tracy N. Hadnott [États-Unis] ; Harley N. Gould [États-Unis] ; Ahmed M. Gharib [États-Unis] ; Carolyn A. Bondy [États-Unis]

Source :

Fertility and sterility [ 0015-0282 ] ; 2011.

RBID : PMC:3130000

Abstract

Objective

To assess fetal and maternal outcomes of pregnancies in women with Turner syndrome (TS).

Design

Retrospective case series.

Setting

Clinical research center.

Patients

276 adults with cytogenetically-proven TS participating in an intramural natural history protocol

Interventions

None.

Main Outcome Measures

Menstrual and obstetric histories, 50-cell karyotypes, and cardiovascular evaluation including aortic diameter measurements.

Results

Our cohort included five women with spontaneous pregnancies and five with pregnancies using assisted reproduction (ART). All five women with spontaneous pregnancies had spontaneous puberty, despite 45,X in ≥90% of their 50-cell karyotype. Participants had a total of 13 pregnancies and 14 live births. One child had cerebral palsy; the others were chromosomally and developmentally normal. Delivery was by Cesarean section in 4/7 spontaneous and 6/6 ART-related pregnancies. One mother experienced pre-eclampsia in an ART-related twin pregnancy requiring preterm delivery; she has marked but stable aortic dilation years later.

Conclusions

Approximately 2% of our study cohort experienced spontaneous pregnancies despite high grade X monosomy, and a similar number achieved pregnancy via oocyte donation and ART. The potential for life-threatening cardiovascular complications warrants comprehensive screening prior to conception, single embryo transfer, and caution regarding unintentional pregnancies for TS women.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3130000

DOI: 10.1016/j.fertnstert.2011.03.085
PubMed: 21496813
PubMed Central: 3130000

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PMC:3130000

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<author><name sortKey="Hadnott, Tracy N" sort="Hadnott, Tracy N" uniqKey="Hadnott T" first="Tracy N" last="Hadnott">Tracy N. Hadnott</name>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title>
<p id="P1">To assess fetal and maternal outcomes of pregnancies in women with Turner syndrome (TS).</p>
</sec>
<sec id="S2"><title>Design</title>
<p id="P2">Retrospective case series.</p>
</sec>
<sec id="S3"><title>Setting</title>
<p id="P3">Clinical research center.</p>
</sec>
<sec id="S4"><title>Patients</title>
<p id="P4">276 adults with cytogenetically-proven TS participating in an intramural natural history protocol</p>
</sec>
<sec id="S5"><title>Interventions</title>
<p id="P5">None.</p>
</sec>
<sec id="S6"><title>Main Outcome Measures</title>
<p id="P6">Menstrual and obstetric histories, 50-cell karyotypes, and cardiovascular evaluation including aortic diameter measurements.</p>
</sec>
<sec id="S7"><title>Results</title>
<p id="P7">Our cohort included five women with spontaneous pregnancies and five with pregnancies using assisted reproduction (ART). All five women with spontaneous pregnancies had spontaneous puberty, despite 45,X in ≥90% of their 50-cell karyotype. Participants had a total of 13 pregnancies and 14 live births. One child had cerebral palsy; the others were chromosomally and developmentally normal. Delivery was by Cesarean section in 4/7 spontaneous and 6/6 ART-related pregnancies. One mother experienced pre-eclampsia in an ART-related twin pregnancy requiring preterm delivery; she has marked but stable aortic dilation years later.</p>
</sec>
<sec id="S8"><title>Conclusions</title>
<p id="P8">Approximately 2% of our study cohort experienced spontaneous pregnancies despite high grade X monosomy, and a similar number achieved pregnancy via oocyte donation and ART. The potential for life-threatening cardiovascular complications warrants comprehensive screening prior to conception, single embryo transfer, and caution regarding unintentional pregnancies for TS women.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article" xml:lang="en"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
  <pmc-dir>properties manuscript</pmc-dir>
  <front><journal-meta><journal-id journal-id-type="nlm-journal-id">0372772</journal-id>
<journal-id journal-id-type="pubmed-jr-id">3705</journal-id>
<journal-id journal-id-type="nlm-ta">Fertil Steril</journal-id>
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<article-id pub-id-type="doi">10.1016/j.fertnstert.2011.03.085</article-id>
<article-id pub-id-type="manuscript">NIHMS290878</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Outcomes of Spontaneous and Assisted Pregnancies in Turner Syndrome: The NIH Experience</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Hadnott</surname>
<given-names>Tracy N</given-names>
</name>
<degrees>BA</degrees>
<xref rid="A1" ref-type="aff">a</xref>
<xref rid="A2" ref-type="aff">b</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gould</surname>
<given-names>Harley N</given-names>
</name>
<degrees>BA</degrees>
<xref rid="A1" ref-type="aff">a</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gharib</surname>
<given-names>Ahmed M</given-names>
</name>
<degrees>MD</degrees>
<xref rid="A3" ref-type="aff">c</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bondy</surname>
<given-names>Carolyn A</given-names>
</name>
<degrees>MD</degrees>
<xref rid="A1" ref-type="aff">a</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>a</label>
Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD</aff>
<aff id="A2"><label>b</label>
Howard Hughes Medical Institute, Chevy Chase, MD</aff>
<aff id="A3"><label>c</label>
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD</aff>
<author-notes><corresp id="FN1">Corresponding Author & Reprint Requests: Carolyn A. Bondy, MD, <email>bondyc@mail.nih.gov</email>
, 10-CRC Hatfield Clinical Research Center, 1-3330, 10 Center Drive, Bethesda, MD 20892-1103, T: (301) 496 – 4686, F: (301) 402 – 0574</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>8</day>
<month>6</month>
<year>2011</year>
</pub-date>
<pub-date pub-type="epub"><day>15</day>
<month>4</month>
<year>2011</year>
</pub-date>
<pub-date pub-type="ppub"><month>6</month>
<year>2011</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>1</day>
<month>6</month>
<year>2012</year>
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<volume>95</volume>
<issue>7</issue>
<fpage>2251</fpage>
<lpage>2256</lpage>
<abstract><sec id="S1"><title>Objective</title>
<p id="P1">To assess fetal and maternal outcomes of pregnancies in women with Turner syndrome (TS).</p>
</sec>
<sec id="S2"><title>Design</title>
<p id="P2">Retrospective case series.</p>
</sec>
<sec id="S3"><title>Setting</title>
<p id="P3">Clinical research center.</p>
</sec>
<sec id="S4"><title>Patients</title>
<p id="P4">276 adults with cytogenetically-proven TS participating in an intramural natural history protocol</p>
</sec>
<sec id="S5"><title>Interventions</title>
<p id="P5">None.</p>
</sec>
<sec id="S6"><title>Main Outcome Measures</title>
<p id="P6">Menstrual and obstetric histories, 50-cell karyotypes, and cardiovascular evaluation including aortic diameter measurements.</p>
</sec>
<sec id="S7"><title>Results</title>
<p id="P7">Our cohort included five women with spontaneous pregnancies and five with pregnancies using assisted reproduction (ART). All five women with spontaneous pregnancies had spontaneous puberty, despite 45,X in ≥90% of their 50-cell karyotype. Participants had a total of 13 pregnancies and 14 live births. One child had cerebral palsy; the others were chromosomally and developmentally normal. Delivery was by Cesarean section in 4/7 spontaneous and 6/6 ART-related pregnancies. One mother experienced pre-eclampsia in an ART-related twin pregnancy requiring preterm delivery; she has marked but stable aortic dilation years later.</p>
</sec>
<sec id="S8"><title>Conclusions</title>
<p id="P8">Approximately 2% of our study cohort experienced spontaneous pregnancies despite high grade X monosomy, and a similar number achieved pregnancy via oocyte donation and ART. The potential for life-threatening cardiovascular complications warrants comprehensive screening prior to conception, single embryo transfer, and caution regarding unintentional pregnancies for TS women.</p>
</sec>
</abstract>
<kwd-group><kwd>fetal outcome</kwd>
<kwd>maternal risk</kwd>
<kwd>pregnancy</kwd>
<kwd>Turner Syndrome</kwd>
</kwd-group>
<funding-group><award-group><funding-source country="United States">National Institute of Child Health & Human Development  : NICHD</funding-source>
<award-id>Z01 HD000628-18 || HD</award-id>
</award-group>
</funding-group>
</article-meta>
</front>
</pmc>
</record>

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Outcomes of Spontaneous and Assisted Pregnancies in Turner Syndrome: The NIH Experience

Outcomes of Spontaneous and Assisted Pregnancies in Turner Syndrome: The NIH Experience

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Abstract

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