Molecular prenatal diagnosis in families with fetal mitochondrial trifunctional protein mutations.
OBJECTIVE
To evaluate the feasibility of molecular prenatal diagnosis in families with mitochondrial trifunctional protein (TFP) mutations and prospectively study the effects of fetal genotype on pregnancy outcome. TFP catalyzes the last 3 steps in mitochondrial long-chain fatty acid oxidation.


METHODS
We performed molecular prenatal diagnosis in 9 pregnancies, 8 in 6 families with isolated long-chain 3-hydroxyacyl-coenzyme A dehydrogenase (LCHAD) deficiency and one in a family with complete TFP deficiency. Analyses were performed on chorionic villous samples in 7 pregnancies and on amniocytes in 2.


RESULTS
Molecular prenatal diagnosis successfully identified the fetal genotype in all 9 pregnancies. Two fetuses were affected, and both pregnancies were terminated by family decision. Two other fetuses had normal genotype and 5 others were heterozygotes. These 7 pregnancies were uncomplicated, and all the offspring are alive and apparently healthy. Genotypes of the aborted fetuses and neonates were confirmed by molecular analysis and enzymatic assays.


CONCLUSIONS
Molecular prenatal diagnosis is possible and valid in guiding management of pregnancies in families with known TFP defects. Women heterozygous for TFP alpha-subunit mutations who carry fetuses with wild-type or heterozygous genotypes have uncomplicated pregnancies.
Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA.
J A
JA
Ibdah
Y
Y
Zhao
J
J
Viola
B
B
Gibson
M J
MJ
Bennett
A W
AW
Strauss
D000649:Amniocentesis; D015193:Chorionic Villi Sampling; D005234:Fatty Liver / Q000209:etiology; D005260:Female; D005838:Genotype; D017359:HELLP Syndrome / Q000209:etiology; D006801:Humans; D008052:Lipid Metabolism, Inborn Errors / Q000175:diagnosis* / Q000235:genetics; D063991:Mitochondrial Trifunctional Protein; D009097:Multienzyme Complexes / Q000172:deficiency* / Q000235:genetics; D010170:Palmitoyl-CoA Hydrolase / Q000172:deficiency* / Q000235:genetics; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology; D011256:Pregnancy Outcome
D009097:Multienzyme Complexes; D063991:Mitochondrial Trifunctional Protein; D010170:Palmitoyl-CoA Hydrolase