Document Detail


Integration of microarray technology into prenatal diagnosis: counselling issues generated during the NICHD clinical trial.
MedLine Citation:
PMID:  22467170     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cytogenetic microarray analysis (CMA) in prenatal testing detects chromosome abnormalities and new genetic syndromes that would be missed by conventional cytogenetics and has the potential to significantly enhance prenatal genetic evaluation. A large Eunice Kennedy Shriver National Institute Of Child Health and Human Development (NICHD)-sponsored multicentered trial to assess the role of CMA as a primary prenatal diagnostic tool has been completed, and results will soon be available. Integration of this technology into clinical care will require thoughtful changes in patient counseling. Here, we examine four cases, all ascertained in the NICHD prenatal microarray study, to illustrate the challenges and subtleties of genetic counseling required with prenatal CMA testing. Although the specifics of each case are distinct, the underlying genetic principles of uncertainty, variable expressivity, and lack of precise genotype-phenotype correlation are well known and already part of prenatal counseling. Counselor and practitioner education will need to include both the science of interpreting array findings as well as development of improved approaches to uncertainty. A team approach to interpretation will need to be developed, as will standardized guidelines by professional organizations and laboratories. Of equal import is additional research into patient attitudes and desires, and a better understanding of the full phenotypic spectrum of copy number variants discovered in utero.
Authors:
Ronald J Wapner; Deborah A Driscoll; Joe Leigh Simpson
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Prenatal diagnosis     Volume:  32     ISSN:  1097-0223     ISO Abbreviation:  Prenat. Diagn.     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-04-02     Completed Date:  2012-09-13     Revised Date:  2014-04-08    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  England    
Other Details:
Languages:  eng     Pagination:  396-400     Citation Subset:  IM    
Copyright Information:
© 2012 John Wiley & Sons, Ltd.
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MeSH Terms
Descriptor/Qualifier:
Adult
Chromosome Aberrations
Chromosome Disorders / diagnosis*,  genetics
Cytogenetics
Famous Persons
Female
Genetic Counseling*
Humans
Molecular Diagnostic Techniques
National Institute of Child Health and Human Development (U.S.)
Oligonucleotide Array Sequence Analysis / methods*
Patient Preference
Pediatrics / methods*,  standards
Pregnancy
Prenatal Diagnosis*
Uncertainty
United States
Grant Support
ID/Acronym/Agency:
R01 HD055651/HD/NICHD NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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