DETERMINAÇÃO PRÉ-NATAL DO SEXO PELA ANÁLISE DE DNA FETAL LIVRE EM PLASMA MATERNO

Abstract

The determination of fetal sex using maternal plasma is a noninvasive prenatal diagnostic test (NIPDT), offered to pregnant women, especially those with an increased risk of having children with conditions X-linked inheritance. Because it is a non-invasive technique, it presents a greater advantage over other methods of invasive prenatal diagnosis such as amniocentesis, cordocentesis and biopsy of chorionic villi. The use of cell free fetal DNA (cffDNA) in maternal plasma has become a promising alternative for the diagnosis of noninvasive and early sex determination. The porpuse this study is to conduct a qualitative test in pregnant women with gestational age ranging from 6 to 20 weeks using the noninvasive prenatal test for the early sex determination of fetal by the real time PCR technique. Twenty-one healthy pregnant women, over 18 years of age, single gestation and attended at the Gynecology and Obstetrics Clinic of the Unigen Laboratory belonging to the Private Health Care Network of the City of Goiânia-GO were selected. After venous blood collection, plasma was separated and frozen (-20 ° C). The material to be analyzed followed the laboratory of the company Qiagen® located in São Paulo, SP, where DNA extraction and purification were performed using fully automated equipment (QIAcube®, with the QIAamp® DNA Micro kit, using the protocol "Purification of viral nucleic acids from large body-fluid samples", according to the manufacturer's specifications), and then the quantitative PCR technique (Rotor-Gene® Qiagen) was run for specific Y-sequence amplification. Of the 21 pregnant women selected, two participants aborted and were excluded from the study. The results showed that, in the 19 cases analyzed, comparing the results of qPCR with fetal sex determined by ultrasonography (USG), 7/19 (36.8%) pregnancies with positive results for the Y chromosome (determining the male sex) and 11/19 (57.9%) pregnancies with a negative result for the Y chromosome (determining the female sex) and only one gestation (5.3%) presented false-negative results for males. The analysis of the concordance index, between the results of the qPCR and the USG, found a concordance of 0.89. These results confirmed a good sensitivity and specificity of the method for the gestation period studied (mean of 12 weeks), indicating that this procedure should be used in the medical routine as an auxiliary tool in cases where fetal sexing becomes necessary for health fetal and/or decreased parents anxiety.