[First trimester fetal sex determination in maternal serum using real-time PCR].
OBJECTIVE
Fetal sex prediction can be achieved using PCR targeted at the SRY gene by analyzing cell-free fetal DNA in maternal serum. Unfortunately, the results reported to date, show lack of sensitivity, especially in the first trimester of pregnancy. Therefore, determination of fetal sex by maternal serum analysis can not replace caryotype analysis following chorionic villus sampling.


METHODS
A new highly sensitive real-time PCR was developed to detect a SRY gene sequence in maternal serum. Analysis was performed on 121 pregnant women during their first trimester of pregnancy (mean gestational age: 11.8 weeks). Among them, 61 had at least one previous male-bearing pregnancy. Results were compared to fetal sex.


RESULTS
SRY PCR analysis of maternal serum was in complete concordance with fetal sex. Among the 121 pregnant women, 61 were bearing a male fetus and 60 a female fetus No false negative results were observed. Furthermore, no false positive results results occurred although 27 women carried female fetus during the current pregnancy, had at least one previous male-bearing pregnancy.


CONCLUSIONS
This study demonstrates that a reliable, non-invasive sex determination can be achieved by PCR analysis of maternal serum during the first trimester of pregnancy. This non-invasive approach for fetal sex prediction should have great implications in the management of pregnant women carriers of an X-linked genetic disorder. Prenatal diagnosis is thus performed for male fetuses only, avoiding invasive procedures and the risk of fetal loss for female fetuses.
Costa
J M
JM
Centre de diagnostic prénatal, hôpital américain de Paris, 63, boulevard Victor-Hugo, 92202 Neuilly, France. jean-marc.costa@ahparis.org
Benachi
A
A
Gautier
E
E
Jouannic
J M
JM
Ernault
P
P
Dumez
Y
Y
D004247:DNA / Q000097:blood*; D005260:Female; D024282:Genes, sry / Q000235:genetics; D005865:Gestational Age; D006801:Humans; D008297:Male; D016133:Polymerase Chain Reaction / Q000379:methods*; D011247:Pregnancy; D012732:Sex Determination Analysis / Q000379:methods*
D004247:DNA