ABSTRACT INTRODUCTION The consequences of de novo balanced structural chromosome aberrations diagnosed antenatally are unpredictable, and, as a result, they introduce uncertainty into genetic counseling decisions. OBJECTIVE Describe de novo balanced structural aberrations present at antenatal diagnosis in samples from pregnant women in five Latin American countries and determine their effect on carrier individuals. METHODS This was a retrospective observational study based on analysis of 109,011 antenatal tests conducted from January 1981 to December 2016 in Cuba, Uruguay, Costa Rica, Mexico, and Colombia. Thirteen cytogenetic laboratories provided information that included the cases analyzed during the study period; number of de novo balanced structural aberrations diagnosed antenatally; number of diagnoses with de novo balanced structural aberrations that resulted in termination of pregnancy; detailed descriptions of the karyotypes of de novo balanced structural aberration carriers, and descriptions of the form of diagnosis, including types of samples used (amniotic fluid, chorionic villus or fetal blood). Each laboratory also provided pathology reports and genetic counseling at time of diagnosis. Postnatal followup for pregnancies carried to term continued for at least two years. RESULTS Of the 109,011 antenatal tests studied, 72 (0.07%) showed de novo balanced structural aberrations. These events primarily involved chromosomes 1, 2, 7, 14, 18, and 20. Of the 79 breakpoints identified, the most common were 5p15.3, 7q11.2, 7q22, and 14q24. We identified three breakpoints corresponding to 3.8% (3q13.1, 3q13.2, and 9p12) that were not reported in other studies of de novo balanced structural aberrations diagnosed antenatally in patients from other geographic regions or in studies of chromosomal fragile sites. Two of these breakpoints (3q13.1 and 3q13.2) were associated with high risk of phenotypic abnormalities. Information on antenatal or postnatal followup was available for 62 (86%) of de novo balanced structural aberration carriers; of the 44 carriers with postnatal followup, 10 had phenotypic abnormalities. CONCLUSIONS Three new de novo breakpoints were identified, presumably related to genetic admixture characteristics in Latin America. Since some diseases associated with de novo balanced structural aberrations detected antenatally have a late onset, followup for at least two years is recommended for carriers of these aberrations. The information in this study is useful in genetic counseling for pregnant women in Latin America.

SUMMARY: A total number of 1 191 prenatal chromosomal studies were carried out from October 1996 to April 1999 in the City of Havana. The most frequent reason for this was the maternal age (70.36 % of total cases). 47 fetuses with chromosomal abnormalities incluiding 17 Down's syndrome cases, 10 structural chromosomal rearranements and 13 mosaique, among others, were detected. T1though the highest number of positive results were found in old pregnant women, the highest risk groups were those in which one parent was a carrier of balanced chromosomal rearrangement and the fetal malformations detected by ultrasound were often associated to chromosomal diseases. All the couples whose test results indicated fetuses with chromosomal imbalance opted for abortion after they received relevant information in specialized visits, following the principle of non-directive genetic counselling.

Durante el período comprendido desde octubre de 1996 hasta abril de 1999 se realizaron un total de 1 191 estudios cromosómicos prenatales. La indicación más frecuente fue la avanzada edad materna (70,36 % del total de casos). Se diagnosticaron 47 fetos con anomalías cromosómicas, incluyendo 17 casos con síndrome de Down, 10 con reordenamientos cromosómicos estructurales y 13 mosaicos, entre otros. Aunque la mayor cantidad de resultados positivos se encontraron en el grupo de gestantes con avanzada edad, los grupos de mayor riesgo fueron los que se estudiaron por ser un padre portador de reordenamiento cromosómico balanceado y también por hallazgos ultrasonográficos de malformaciones fetales frecuentemente asociadas con enfermedades cromosómicas. La totalidad de parejas en las que se encontraron resultados de fetos con desbalances cromosómicos optaron por realizarse interrupciones de los embarazos, después de recibir la información correspondiente en consultas especializadas, siguiendo el principio del asesoramiento genético no directivo.

A case of diploid-tetraploid mixoploidy with mild clinical signs correspondoing to this condition of polyploidy in humans is presented. Cytogenetic studies based on cultures of peripheral blood and fibroblasts of skin allowed to obtain the 46,XX/92XXXX chromosomic formula in the patient. The phenotype-kariotype correlation was stablished and its clinical presentation was made. This study of cases helps to improve the knowledge about this condition, and it also contributes to have a better diagnosis and to dilucidate the etiology of unspecific syndromes of malformation.

Se presenta un caso de mixoploidía diploide-tetraploide, con ligeros signos clínicos pertenecientes a esta condición de la poliploidía en humanos. Estudios citogenéticos a partir de cultivos de sangre periférica y fibroblastos de piel permitieron establecer la fórmula cromosómica 46,XX/92XXXX en la paciente. Se realiza correlación fenotipocariotipo, así como su presentación clínica. Este estudio de casos ayuda a enriquecer el conocimiento sobre esta condición, contribuye a su mejor diagnóstico y a dilucidar la etiología de síndromes malformativos inespecíficos.