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Objective: The aim of this study was to investigate the value of genetic testing using exome sequencing (ES) in oligohydramnios pregnancies with or without other structural abnormalities., Materials and Methods: A total of 110 singleton pregnancies complicated by oligohydramnios were enrolled, including 52 of isolated oligohydramnios and 58 of non-isolated oligohydramnios. All fetal samples were first tested by quantitative fluorescent polymerase chain reaction (QF-PCR) and followed by chromosomal microarray analysis (CMA). Those with normal CMA were informed of the option of trio ES., Results: QF-PCR detected chromosomal abnormality in 4 cases (4/110, 3.6%), including 1 of XXY, 1 of XYY and 2 of triploidy. The remaining 106 cases were tested by CMA, with pathogenic copy number variations (CNVs) detected in 5 cases (5/106, 4.7%), and uniparental disomy (UPD) in 2 cases (2/106, 1.9%). As an option for cases with a normal CMA, ES was accepted by 12 non-isolated cases, and pathogenic or likely pathogenic variants were detected in 5, involving the following genes: PBX1, FREM2, PKHD1 and BBS2, with a 41.7% (5/12) diagnostic rate., Conclusion: We provided further evidence of using advanced genetic approaches for oligohydramnios pregnancy. Non-isolated oligohydramnios increases the risk of having monogenetic conditions., Competing Interests: Declaration of competing interest The author declares that has no conflict of interest regarding the publication of this paper., (Copyright © 2024. Published by Elsevier B.V.)

Objective: To explore the clinical phenotype and genetic variants of a fetus with Glutaracidemia type II C (GA II C)., Methods: Clinical data of a 32-year-old pregnant woman and her fetus with GA II C diagnosed at the Third Affiliated Hospital of Zhengzhou University in December 2021 due to the enlargement and enhanced echo of the kidneys and oligohydramnios fluid at 17 weeks were analyzed retrospectively. Amniotic fluid sample of the fetus and peripheral blood samples of the couple were collected for whole exome sequencing (WES). Candidate variants were verified by Sanger sequencing. Copy number variation (CNV) was detected by using low-coverage whole genome sequencing (CNV-seq)., Results: At 18 weeks' gestation, ultrasound revealed that the fetus had enlargement and enhanced echo of the kidneys along with no echo of renal parenchymal tubular fissure and oligohydramnios. MRI at 22 weeks' gestation confirmed that both kidneys were enlarged with uniformly increased abnormal T2 signal and decreased DWI signal. The volume of both lungs was small, with slightly higher T2 signal. No CNV was detected in the fetus. WES revealed that the fetus has harbored compound heterozygous variants of the ETFDH gene, namely c.1285+1G＞A and c.343_344delTC, which were inherited from its father and mother, respectively. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), both variants were classified as pathogenic (PVS1+PM2_Supporting+PS3_Supporting; PVS1+PM2_Supporting+PM3)., Conclusion: The c.1285+1G＞A and c.343_344delTC compound heterozygous variants of the ETFDH gene probably underlay the disease in this fetus. Type II C glutaric acidemia may manifest as bilateral kidney enlargement with enhanced echo and oligohydramnios. Discovery of the c.343_344delTC has enriched the spectrum of ETFDH gene variants.