What's New in Prenatal Genetics? A Review of Current Recommendations and Guidelines.

IMPORTANCE: The rapid development of prenatal genetic testing and screening tools and choices constantly challenges clinicians to stay up to date on current best practice. OBJECTIVE: We sought to review, compare, and summarize recent national society guidelines on prepregnancy genetic screening and prenatal diagnosis for aneuploidy with a focus on changes and additions to previous guidelines. EVIDENCE ACQUISITION: We performed a descriptive review of 8 recently published (2016-2017) national guidelines and updates on prenatal genetic screening and testing including American Congress of Obstetricians and Gynecologists committee opinions and practice bulletins, Society for Maternal-Fetal Medicine consult series publications, and an American College of Medical Genetics and Genomics position statement. Topics included carrier screening, cell-free DNA screening, chromosomal microarray analysis, next-generation sequencing, and prenatal diagnostic testing. The recommendations in these publications were compared, and the additions and changes to previous recommendations and guidelines were summarized. RESULTS: Recent publications contain many updates and changes to previous screening and testing strategies, most of which are consistent between professional societies. Although many new technologies have been integrated into prenatal diagnosis, some newer technologies are not yet routinely recommended for widespread use, often because of lack of clinical trials and validation studies. CONCLUSIONS: Prenatal screening and testing options are rapidly expanding. To provide best-practice prenatal care, obstetric care providers should educate themselves about the most up-to-date recommendations and be prepared to interpret and apply these guidelines to their patients. Society guidelines are largely in agreement.

Duke Scholars

Author Jeffrey Adam Kuller Obstetrics and Gynecology, Maternal Fetal Medicine