Antenatal Diagnosis of Fetal Abnormalities by N. C. Nevin (auth.), James O. Drife MD, FRCSEd, FRCOG, Dian

By N. C. Nevin (auth.), James O. Drife MD, FRCSEd, FRCOG, Dian Donnai MBBS, FRCP, DCH, DObst, RCOG (eds.)

In few components of drugs is growth extra unbelievable than within the box of prenatal analysis. New medical concepts corresponding to chorion villus sampling, specified ultrasound scanning and cordocentesis are being evaluated by way of obstetricians, and refinement of biochemical trying out is widening the scope of maternal serum screening. within the laboratory, dramatic advances in molecular biology are taking place: households vulnerable to genetic illness could be investigated with gene probes, and preimplantation analysis of the embryo is now becom­ ing a truth. those technical advances have vital moral and useful implications, between to be able to be an extra elevate in public expectancies of the factors required of antenatal providers. Clini­ cians will desire a excessive measure of ability to notify fit girls concerning the recommendations for screening basic pregnancies, and to assistance high-risk girls in regards to the merits and barriers of prenatal prognosis. Obstetricians, scientists and well-being carrier managers will face the tricky activity of identifying how prenatal prognosis might be made to be had to ladies in a being concerned and most economical method. Recognising the speedy growth during this box, the Royal collage of Obstetricians and Gynaecologists made prenatal prognosis the topic of its twenty third examine staff. a global panel of top researchers, whose services ranged from molecular biology to philosophy, used to be invited to take part in a 3 day workshop, with time for in-depth dialogue in addition to the presentation of papers.

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For example, such things as "Beware of the transient hygromatous change", or "You do not have to do a C-section for this or that condition, but it is worth (or not worth) sending that patient to a centre for delivery" . I am happy with it as it is developing, but I hope it stays on the rails, otherwise initial enthusiasm will run out of steam. WiUiamson: I would like to comment on Professor J. Harris's questions as far as they are relevant to DNA analysis of thalassaemia, cystic fibrosis, Duchenne muscular dystrophy and Friedreich's ataxia.

We cannot afford the luxury of continuing to employ unvalidated screening routines, and we cannot assume that what is shown to work in a specialised research setting, with skilled and motivated research staff, still works reliably when employed in everyday clinical practice. It is possible that some screening programmes currently do more harm than good. Antenatal diagnosis does not always increase a child's chance of survival. 3). The voluntary collaborative register now in operation in the Northern Region makes it possible to monitor, for the first time, the efficacy of the antenatal and perinatal techniques now being developed to screen for significant fetal abnormality (structural, metabolic or genetic) both during pregnancy and in early infancy.

9. Allan LD, Crawford DC, Chita SK, Tynan MJ. Prenatal screening for congenital heart disease. Br Med J 1986; 292:1717-19. Routine Fetal Anomaly Screening 43 10.

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