RASopathies: A significant cause of polyhydramnios?

Prenat Diagn. 2021 Feb;41(3):362-367. doi: 10.1002/pd.5862. Epub 2020 Nov 18.

Abstract

Objective: The aim of the study is to determine the prevalence of RASopathies in a polyhydramnios cohort selected by postnatal medical genetics evaluation.

Methods: In this retrospective study, we reviewed 622 pregnancies with polyhydramnios seen at Lucile Packard Children's Hospital between 2008 and 2017. The findings from 131 cases evaluated by Medical Genetics were included in our final analysis. Genetic testing information was extracted to determine the rate of chromosomal or single gene conditions focusing on the RASopathies. Additional variables collected were: maternal characteristics, ultrasound findings, and the severity and timing of diagnosis of polyhydramnios.

Results: Postnatal genetic testing or clinical examination identified a genetic disorder in 63 (48.1%) cases, more than half (n = 33) of which had a single gene condition. Postnatal testing revealed an underlying RASopathy in 15 (11.5%) cases. An underlying RASopathy was significantly associated with the severity and timing of polyhydramnios (p < 0.05).

Conclusion: Focusing on a selected cohort postnatally evaluated by Medical Genetics, our study identified a chromosomal or genetic disorder in almost half of pregnancies complicated by polyhydramnios. Specifically, an underlying RASopathy was found in 11.5% of cases with 13/15 of these cases having additional ultrasound findings.

MeSH terms

  • Adult
  • Arteriovenous Malformations / diagnosis
  • Arteriovenous Malformations / epidemiology
  • Arteriovenous Malformations / genetics
  • Capillaries / abnormalities
  • Cohort Studies
  • Costello Syndrome / diagnosis
  • Costello Syndrome / epidemiology
  • Costello Syndrome / genetics
  • Ectodermal Dysplasia / diagnosis
  • Ectodermal Dysplasia / epidemiology
  • Ectodermal Dysplasia / genetics
  • Facies
  • Failure to Thrive / diagnosis
  • Failure to Thrive / epidemiology
  • Failure to Thrive / genetics
  • Female
  • Genetic Testing / methods
  • Genetic Testing / statistics & numerical data
  • Heart Defects, Congenital / diagnosis
  • Heart Defects, Congenital / epidemiology
  • Heart Defects, Congenital / genetics
  • Humans
  • Noonan Syndrome / diagnosis
  • Noonan Syndrome / epidemiology
  • Noonan Syndrome / genetics
  • Polyhydramnios / diagnosis*
  • Polyhydramnios / epidemiology
  • Polyhydramnios / genetics*
  • Port-Wine Stain / diagnosis
  • Port-Wine Stain / epidemiology
  • Port-Wine Stain / genetics
  • Pregnancy
  • Prevalence
  • Retrospective Studies
  • Ultrasonography, Prenatal / methods
  • Ultrasonography, Prenatal / statistics & numerical data

Supplementary concepts

  • Capillary Malformation-Arteriovenous Malformation
  • Cardiofaciocutaneous syndrome