title: A de novo duplication of chromosome 9q34.13-qter in a fetus with Tetralogy of Fallot Syndrome.
abstract: BACKGROUND
  Partial duplications of the distal 9q have been rarely reported in literatures. The key features included characteristic facial appearance, long fingers and toes, slight psychomotor retardation, heart murmur et al. But rare severe congenital heart defects (CHD) such as TOF were reported to be associated with 9qter duplications.
  
  
  METHODS
  A 23-year-old woman was referred for genetic counseling and prenatal diagnosis at 25(3/7) weeks of gestation due to her male fetus, diagnosed as Tetralogy of Fallot Syndrome (TOF) by prenatal ultrasound. SNP (Single nucleotide polymorphism) array revealed that the male fetus had a de novo 5.47 Mb duplication at 9q34.13-qter. Meanwhile, non-invasive prenatal testing (NIPT) using low coverage whole genome massively parallel sequencing of circulating cell-free fetal DNA (cffDNA) showed consistent results. Multiplex ligation-dependent probe amplification (MLPA) also confirmed the duplication at 9qter.
  
  
  CONCLUSIONS
  In this paper, we present an Asian fetus with TOF caused by a de novo 5.47 Mb duplication at 9q34.13-qter. Duplication of 9q34.13-qter should be considered as an etiological diagnosis in the case of TOF. Our prenatal diagnostic findings provide important information for genetic counseling on the male fetus and future pregnancies in this family. Chromosomal microarray analysis (CMA) remains the first-tier clinical diagnostic test for prenatal fetus with suspicious syndromes. We also highlight the high potential application of NIPT in the screening of sub-chromosomal rearrangement.
authors.affiliation: Prenatal Diagnosis Center of Province Hunan, The Maternal and Child Health Care Hospital of Hunan province, Changsha, Hunan 410008 People's Republic of China.
authors.forename: Jing
authors.initials: J
authors.lastname: Liu
authors.affiliation: Prenatal Diagnosis Center of Province Hunan, The Maternal and Child Health Care Hospital of Hunan province, Changsha, Hunan 410008 People's Republic of China.
authors.forename: Hao
authors.initials: H
authors.lastname: Hu
authors.affiliation: Prenatal Diagnosis Center of Province Hunan, The Maternal and Child Health Care Hospital of Hunan province, Changsha, Hunan 410008 People's Republic of China.
authors.forename: Na
authors.initials: N
authors.lastname: Ma
authors.affiliation: Prenatal Diagnosis Center of Province Hunan, The Maternal and Child Health Care Hospital of Hunan province, Changsha, Hunan 410008 People's Republic of China.
authors.forename: Zhengjun
authors.initials: Z
authors.lastname: Jia
authors.affiliation: Prenatal Diagnosis Center of Province Hunan, The Maternal and Child Health Care Hospital of Hunan province, Changsha, Hunan 410008 People's Republic of China.
authors.forename: Yuchun
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Prenatal Diagnosis Center of Province Hunan, The Maternal and Child Health Care Hospital of Hunan province, Changsha, Hunan 410008 People's Republic of China.
authors.forename: Jiancheng
authors.initials: J
authors.lastname: Hu
authors.affiliation: Prenatal Diagnosis Center of Province Hunan, The Maternal and Child Health Care Hospital of Hunan province, Changsha, Hunan 410008 People's Republic of China.
authors.forename: Hua
authors.initials: H
authors.lastname: Wang
keywords: 9qter duplication; Non-invasive prenatal testing; Prenatal diagnosis; SNP array; TOF