NIPT (Contd) :-What is meant by digital
polymerase chain reactions (PCR)
and massively parallel sequencing (MPS)????
What do we mean by cell free foetal DNA –used for
detection of A) aneuploidy of foetus in
utero B) sex determination of foetus C)
and Rh status of foetus. A scientific breakthrough came in 1997 with the
recognition that it was not necessary to detect intact fetal cells but(that
maternal plasma contained within it fetal cell-free DNA (cfDNA) . It has been
shown that this material mainly originates from fetal trophoblast and consists
of relatively short fragments of fetal DNA (143 base pairs on average). Recent
work has demonstrated that cfDNA
represents the whole of the fetal genome than intact fetal cells.
Firstly, cfDNA of fetal origin is present in
relatively large quantities, representing up to 20% of the total
maternal plasma DNA in later pregnancy.
It is also found from early in pregnancy, even from
4-5 weeks’ gestation.
Furthermore, it is very rapidly cleared from the
maternal circulation (with a half-life of 16 minutes) making it no longer
detectable only hours after delivery.
The challenge is that fetal DNA still only represents
a minority partner, mixed amongst the maternal DNA, and as such deciphering the
fetal from the maternal signature is the major technical challenge.
However, technological advances such as digital polymerase chain reactions (PCR) and massively parallel
sequencing (MPS), which enable
the far more precise enumeration of genes
present in cfDNA, now mean that the far
more difficult challenge of identifying a fetus with aneuploidy or even the
sequencing of the entire fetal genome are now becoming a reality.
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