Prenatal genetic diagnosis of cardiac rhabdomyoma: A single-center experience

Eur J Obstet Gynecol Reprod Biol. 2020 Jun:249:7-10. doi: 10.1016/j.ejogrb.2020.03.051. Epub 2020 Apr 10.

Abstract

Objective: The aim of this study is to review our institution's experience with fetal cardiac rhabdomyoma, and to document the prenatal genetic testing for tuberous sclerosis complex (TSC) and clinical outcome of the affected pregnancies.

Study design: During a four-year period, patients with fetal cardiac rhabdomyoma were detected by echocardiography in the second trimester of pregnancy. Molecular genetic analysis was conducted on fetuses to screen for variants of TSC1/TSC2 genes. We reviewed medical records of these affected pregnancies, including maternal demographics, sonographic findings, genotyping results and pregnancy outcomes.

Results: Eleven cases with fetal cardiac rhabdomyoma were studied during the study period. A pathogenic variant of TSC1/TSC2 genes was detected in all cases, including two with an inherited variant and nine with a de novo variant. Out of these eleven cases diagnosed prenatally, eight pregnancies were terminated and three continued till term.

Conclusions: Cardiac rhabdomyoma is the prenatal sign of TSC. A molecular investigation of TSC1/TSC2 genes should be recommended for fetuses with a rhabdomyoma and the parents, and the prognostic counselling should include TSC and its consequences.

Keywords: Fetal rhabdomyoma; Genetic counseling; TSC1 or TSC2 genes; Tuberous sclerosis complex.

MeSH terms

  • Adult
  • Echocardiography / methods
  • Female
  • Fetal Diseases / diagnosis*
  • Fetal Diseases / genetics
  • Fetal Heart / diagnostic imaging
  • Fetal Heart / embryology
  • Genetic Testing / methods*
  • Genetic Variation / genetics
  • Heart Neoplasms / diagnosis*
  • Heart Neoplasms / embryology
  • Heart Neoplasms / genetics
  • Humans
  • Pregnancy
  • Pregnancy Outcome
  • Prenatal Diagnosis / methods*
  • Prospective Studies
  • Rhabdomyoma / diagnosis*
  • Rhabdomyoma / embryology
  • Rhabdomyoma / genetics
  • Tuberous Sclerosis Complex 1 Protein / genetics
  • Tuberous Sclerosis Complex 2 Protein / genetics

Substances

  • TSC1 protein, human
  • TSC2 protein, human
  • Tuberous Sclerosis Complex 1 Protein
  • Tuberous Sclerosis Complex 2 Protein