Tips offered for management of genetic conditions in pregnancy
Noting that advances in understanding of genetic conditions, reproductive technologies, and improved medical and surgical care is allowing an increased number of women to achieve normal pregnancy outcome, researchers from the ACOG Committee on Genetics discuss the management of genetic conditions during pregnancy.
The authors note that management of certain genetic conditions is complex and may necessitate a multidisciplinary approach from before conception through the postpartum period. A preconception evaluation with obstetrician-gynecologists, genetics specialists, maternal-fetal medicine specialists, or other appropriate subspecialists is recommended in order to optimize care for patients with certain genetic conditions, or those at risk of having a particular genetic condition. Preimplantation genetic testing with in vitro fertilization should be offered to patients with established causative mutations for a genetic condition and who desire prenatal genetic testing. Once pregnant, patients should undergo initial examination early in the first trimester to allow for coordination of prenatal screening or testing and assessment of pregnancy risks.
"In treating women with genetic conditions during pregnancy, we must consider not just the health of the woman and her ability to carry and deliver a baby safely," Joseph R. Biggio Jr., M.D., chair of the College's Committee on Genetics, said in a statement. "Ob-gyns must also consider that women with these rare medical conditions may rely on medications that might have a teratogenic effect on the fetus, leading to potential complications during infancy and childhood and even into adulthood. However, in some cases, it may be medically necessary to continue medication."
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