This purpose of this study is to develop noninvasive methods of prenatal diagnosis. Fetal cells can be found in maternal blood. This study is designed to isolate these fetal cells from a sample of the pregnant woman’s blood and use those cells to test for fetal chromosome abnormalities.

Condition
Chromosome Disorders

Further Study Details: 

Expected Total Enrollment:  3500

Fetal cells can be recovered from maternal blood, suggesting that noninvasive prenatal diagnosis is possible. However, recovery and analysis of fetal cells from maternal blood is complex and sensitivity is low because of the rarity of these cells in the maternal circulation. This study was designed to develop a noninvasive, safe, relatively inexpensive, and accurate technique for the prenatal diagnosis of genetic disorders in the first trimester.

The study included a systematic evaluation of variables involved in separating and enriching fetal cells isolated from maternal blood through fluorescence activated cell sorting (FACS) and magnetic activated cell sorting (MACS) followed by fluorescent in situ hybridization (FISH) with chromosome-specific DNA probes. The results of these tests were compared to those obtained from amniocentesis or chorionic villus sampling (CVS) on the same women. No clinical decision was made based on the results of the experimental diagnostic/screening technique.

Even if the biological risks associated with reproductive genetic technologies are reduced, it is possible that other risks (or benefits) are associated with the procedures. Some of these factors may be: increased or diminished maternal anxiety, increased adjustment or maladaption to the pregnancy, increased feelings of coercion to undertake the procedure, and increased or decreased comfort with reproductive decision-making. The study also assessed whether there were any nonbiological or psychological effects on the women undergoing prenatal diagnostic testing.

After the first five years of the study, preliminary analysis of the data showed that the sensitivity of aneuploidy detection using fetal cell analysis from maternal blood is comparable to single marker prenatal serum screening, but technological advances are needed before fetal cell analysis has clinical application as part of a multiple maker method for noninvasive prenatal screening. Target cell recovery and fetal cell detection were better using MACS than with FACS. The detection rate of finding at least one aneuploid cell in cases of fetal aneuploidy was 74.4%.

Ages Eligible for Study:  16 Years   -   45 Years,  Genders Eligible for Study:  Female

Criteria

Inclusion Criteria

• Pregnant
• Abnormal serum marker profile (alpha-fetoprotein, hCG, estriol)
• Ultrasound abnormalities of the fetus
• Any high risk indicator for aneuploidy as determined by physician

Illinois
      University of Illinois at Chicago, Chicago,  Illinois,  United States
Massachusetts
      New England Medical Center Hospital, Boston,  Massachusetts,  United States
Michigan
      Wayne State University, Detroit,  Michigan,  United States
Pennsylvania
      Jefferson Medical College, Philadelphia,  Pennsylvania,  19107-5563,  United States
Texas
      Baylor College of Medicine, Houston,  Texas,  United States

Study chairs or principal investigators

Laird Jackson, MD,  Principal Investigator
Diana Bianchi, MD,  Principal Investigator
Mark Evans, MD,  Principal Investigator
Sherman Elias, MD,  Principal Investigator

Study ID Numbers:  NICHD-NIFTY; 1N01HD43201; 1N01HD43202; 1N01HD43203; 1N01HD43204
Record last reviewed:  June 2003
Last Updated:  October 13, 2004
Record first received:  July 10, 2003
ClinicalTrials.gov Identifier:  NCT00064597
Health Authority: United States: Federal Government
ClinicalTrials.gov processed this record on 2005-04-08