Mothers-to-be now have an additional option for non-invasive prenatal screening to detect Down's Syndrome and related disorders.
Pregnant women typically go through standard screening during their first two trimesters to help identify chances of chromosomal abnormalities. This includes a series of blood tests and ultrasound scans. The detection rate for Down's Syndrome with these methods ranges from 65 per cent to 96 per cent.
But a non-invasive alternative called "next generation sequencing" is now available in the UAE. It involves drawing 10ml of blood from the mother and analysing the cell-free DNA that is shared between the mother and the foetus. A laboratory will isolate the foetal DNA and count the chromosomes.
Normally, chromosomes come in pairs.
With Down's Syndrome, an extra chromosome is present – a condition known as trisomy.
Although the genetic test can pick up an unusual number of chromosomes, it can only specifically identify abnormalities in chromosomes 21, 18 and 13, which cause Down's Syndrome, Edwards' Syndrome and Patau's Syndrome.
The test is being offered by Trigene through Eastern Biotech and Life Sciences in Dubai, and patients can go directly there or be referred by their doctor.
Women identified to be at high risk have few alternatives other than amniocentesis – an invasive procedure using a needle inserted into the mother's uterus to draw fluid for testing, or Chorionic Villi Aspiration sampling (CVS) – in which a catheter is inserted into the uterus to collect a foetal sample.
In addition to the discomfort, both procedures carry a small risk of miscarriage: amniocentesis at 0.5 to 1 per cent and CVS at up to 2 per cent.
The new technique "is very exciting", said Dr Kulsoom Masood, a gynaecologist at Al Kamal Medical Centre in Sharjah. "For more than 10 years, scientists have been trying to get to the foetal cell-free DNA and they've finally done it. Why subject a patient to pain and discomfort if it is not necessary?"
Cost is the biggest obstacle, Dr Masood said. The screening is not usually covered by insurance and costs about Dh2,000 more than an amniocentesis.
"But I definitely think this will go down as more people demand it," she said.
Dr Amala Nazareth, a gynaecologist at Prime Healthcare Centre in Dubai, has already referred several of her patients.
"It should be recommended to women who are at high risk, those who are over the age of 35, have had abnormal screenings, a past of [foetal] complications or a family history," she said.
The procedure has been clinically validated and is internationally recognised. According to the American Congress of Obstetricians and Gynaecologists (Acog), the technology can be expected to identify about 98 per cent of Down's Syndrome cases with a false-positive rate of less than 0.5 per cent. However, Acog warned that cell-free foetal DNA testing should not be offered to low-risk women or women carrying multiples because it has not been sufficiently evaluated in these groups. It also said that the test should not replace the accuracy of prenatal diagnosis with CVS or amniocentesis.
However, a clinical validation study published in 2010 in the British Medical Journal of 753 pregnant women at high risk of having a child with Down's Syndrome concluded that if referrals for amniocentesis or CVS were based on the new test results, about 98 per cent of the invasive diagnostic procedures could have been avoided.
The test being offered by Eastern Biotech has, so far, no documented cases of false-negatives with a false-positive rate of 0.03 per cent. Another important benefit of the new technology is time, said Dr Sanjida Ahmed, research director at Eastern Biotech.
"Women can be tested as early as 12 weeks and results are provided within two weeks, compared with amniocentesis, which can only be done as early as 16 weeks and another two or three weeks are needed for the results," she said.
"This way mothers can prepare themselves and say: 'OK, I'm going to have a baby with this kind of condition, but now I have an opportunity to learn how to handle it'."
Because of the mixed opinions of the medical community, experts are careful not to suggest the genetic testing for every patient as a replacement for invasive procedures.
"It is a paradigm shift in case of detection but it is hard to convince the doctors and patients at this time," Dr Ahmed said. "We are working hard to change that."
mismail@thenational.ae
The National's picks
4.35pm: Tilal Al Khalediah
5.10pm: Continous
5.45pm: Raging Torrent
6.20pm: West Acre
7pm: Flood Zone
7.40pm: Straight No Chaser
8.15pm: Romantic Warrior
8.50pm: Calandogan
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The Penguin
Starring: Colin Farrell, Cristin Milioti, Rhenzy Feliz
Creator: Lauren LeFranc
Rating: 4/5
Specs
Engine: 51.5kW electric motor
Range: 400km
Power: 134bhp
Torque: 175Nm
Price: From Dh98,800
Available: Now
At a glance
Global events: Much of the UK’s economic woes were blamed on “increased global uncertainty”, which can be interpreted as the economic impact of the Ukraine war and the uncertainty over Donald Trump’s tariffs.
Growth forecasts: Cut for 2025 from 2 per cent to 1 per cent. The OBR watchdog also estimated inflation will average 3.2 per cent this year
Welfare: Universal credit health element cut by 50 per cent and frozen for new claimants, building on cuts to the disability and incapacity bill set out earlier this month
Spending cuts: Overall day-to day-spending across government cut by £6.1bn in 2029-30
Tax evasion: Steps to crack down on tax evasion to raise “£6.5bn per year” for the public purse
Defence: New high-tech weaponry, upgrading HM Naval Base in Portsmouth
Housing: Housebuilding to reach its highest in 40 years, with planning reforms helping generate an extra £3.4bn for public finances
Kibsons%20Cares
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NO OTHER LAND
Director: Basel Adra, Yuval Abraham, Rachel Szor, Hamdan Ballal
Stars: Basel Adra, Yuval Abraham
Rating: 3.5/5
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Results
Stage 7:
1. Caleb Ewan (AUS) Lotto Soudal - 3:18:29
2. Sam Bennett (IRL) Deceuninck-QuickStep - same time
3. Phil Bauhaus (GER) Bahrain Victorious
4. Michael Morkov (DEN) Deceuninck-QuickStep
5. Cees Bol (NED) Team DSM
General Classification:
1. Tadej Pogacar (SLO) UAE Team Emirates - 24:00:28
2. Adam Yates (GBR) Ineos Grenadiers - 0:00:35
3. Joao Almeida (POR) Deceuninck-QuickStep - 0:01:02
4. Chris Harper (AUS) Jumbo-Visma - 0:01:42
5. Neilson Powless (USA) EF Education-Nippo - 0:01:45
Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”
The%20specs
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COMPANY%20PROFILE
%3Cp%3E%3Cstrong%3ECompany%3A%3C%2Fstrong%3E%20Eco%20Way%3Cbr%3E%3Cstrong%3EStarted%3A%3C%2Fstrong%3E%20December%202023%3Cbr%3E%3Cstrong%3EFounder%3A%3C%2Fstrong%3E%20Ivan%20Kroshnyi%3Cbr%3E%3Cstrong%3EBased%3A%3C%2Fstrong%3E%20Dubai%2C%20UAE%3Cbr%3E%3Cstrong%3EIndustry%3A%3C%2Fstrong%3E%20Electric%20vehicles%3Cbr%3E%3Cstrong%3EInvestors%3A%3C%2Fstrong%3E%20Bootstrapped%20with%20undisclosed%20funding.%20Looking%20to%20raise%20funds%20from%20outside%3Cbr%3E%3C%2Fp%3E%0A
The specs
Engine: 2.0-litre 4-cylturbo
Transmission: seven-speed DSG automatic
Power: 242bhp
Torque: 370Nm
Price: Dh136,814
Vidaamuyarchi
Director: Magizh Thirumeni
Stars: Ajith Kumar, Arjun Sarja, Trisha Krishnan, Regina Cassandra
Rating: 4/5
Formula Middle East Calendar (Formula Regional and Formula 4)
Round 1: January 17-19, Yas Marina Circuit – Abu Dhabi
Round 2: January 22-23, Yas Marina Circuit – Abu Dhabi
Round 3: February 7-9, Dubai Autodrome – Dubai
Round 4: February 14-16, Yas Marina Circuit – Abu Dhabi
Round 5: February 25-27, Jeddah Corniche Circuit – Saudi Arabia