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Perinatology

Perinatology

Preconception Counseling

What is pre-conception counseling?

Pre-conception counseling is a meeting between a patient and a genetic counselor and/or physician that occurs prior to pregnancy. The session provides information regarding potential risks for a future pregnancy and clarifies a person's options with regard to having children. If appropriate, the patient may receive suggestions for screening tests or suggestions regarding which exposures that she may wish to avoid prior to and during a pregnancy. These are only recommendations that a patient may consider regarding future child bearing.

Who performs pre-conception counseling?

Often, a physician and a genetic counselor will meet with a patient. Whether or not a session will be performed by a perinatologist (also known as a high-risk obstetrician) or in combination with a genetic counselor, depends on the reason for the pre-conception counseling. Generally, a genetic counselor will be consulted before the physician, if the referral is based on genetic concerns, or if the woman requests information on specific medications that she is taking. On the other hand, a consult with a perinatologist may occur if the reason for pre-conception counseling is related to an existing or previous illness, or if the reason for the referral is related to complications that occurred in a prior pregnancy.

Who should go for pre-conception counseling?

Pre-conception counseling may be offered for many reasons. If there is a family history of a genetic condition, a person may have pre-conception counseling to make her aware of available testing and to determine if a future pregnancy may be at risk. If a woman has a chronic illness (such as diabetes or hypertension), she may opt for pre-conception counseling to better understand the potential risks. She may also want to know what effects, if any, her medications may have on a developing baby. If medically appropriate, the physician may suggest changing a medication or reducing the dosage. One should never alter medications taken for chronic illness without consulting a physician. If it is suggested that a woman continue her medication, the pre-conception counseling session may include a review of the available screening and testing options for reassurance during a future pregnancy.

Since there are so many prenatal screening and testing options available, some patients will ask for pre-conception counseling simply to learn about such options for a future pregnancy.

What does a person's ethnic background have to do with pre-conception counseling?

Some genetic conditions can be found more often in people of specific ethnic backgrounds or ancestries. For example, people of Northern European ancestry, such as English, Irish and German, may be offered cystic fibrosis carrier screening, while someone of African American ancestry may be offered sickle cell anemia carrier screening. Also, people of Mediterranean (Italian, Spanish, Greek) ancestry may be offered b -thalassemia screening, and those of Asian descent may be offered a -thalassemia screening. People of Eastern European Jewish (Ashkenazi) descent may be offered carrier screening for several disorders including Tay-Sachs disease, Canavan disease, cystic fibrosis, Gaucher disorder, Niemann-Pick disease, Fanoci anemia and Bloom syndrome.

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