Menu Expand
Reproductive Genetics, An Issue of Obstetrics and Gynecology Clinics, E-Book

Reproductive Genetics, An Issue of Obstetrics and Gynecology Clinics, E-Book

Lorraine Dugoff

(2018)

Additional Information

Book Details

Abstract

This issue provides a timely update for for the ob/gyn on genetics in reproductive medicine. Dr. Dugoff has created an issue with the goals of providing the most currently clinical information on genetic screening and prenatal genetics. Top authors have written reviews on the following topics: Genetic counseling overview for the ob/gyn; Cell-free DNA screening for aneuploidy; Cell-free DNA screening for single gene disorders; The use of microarray in prenatal diagnosis; Whole exome sequencing: Applications in prenatal diagnosis; Screening for aneuploidy in multiple gestations: The challenges and available options; Expanded carrier screening; Ethnicity-based carrier screening overview; Prenatal genetic diagnosis and prenatal genetic screening; Ethical issues in prenatal genetics; Ultrasound findings and associated genetic syndromes; Hereditary cancers in gynecology: and What physicians should know about genetic testing, screening and risk reduction. Readers will come away with the knowledge they need to diagnose, treat, and manage patients based on the most current evidence and data.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Reproductive Genetics i
Copyright\r ii
Contributors iii
CONSULTING EDITOR iii
EDITOR iii
AUTHORS iii
Contents vii
Foreword: Update on Reproductive Genetics: What an Obstetrician-Gynecologist Needs to Know vii
Preface: Reproductive Genetics vii
Genetic Counseling Overview for the Obstetrician-Gynecologist vii
Cell-Free DNA Screening for Aneuploidy and Microdeletion Syndromes vii
Cell-Free DNA: Screening for Single-Gene Disorders and Determination of Fetal Rhesus D Genotype vii
Screening for Aneuploidy in Multiple Gestations: The Challenges and Options viii
The Use of Chromosomal Microarray Analysis in Prenatal Diagnosis viii
Whole Exome Sequencing: Applications in Prenatal Genetics viii
Ethnicity-Based Carrier Screening viii
Expanded Carrier Screening ix
Preimplantation Genetic Screening and Preimplantation Genetic Diagnosis ix
Key Ethical Issues in Prenatal Genetics: An Overview ix
The Status of Genetic Screening in Recurrent Pregnancy Loss ix
Hereditary Cancers in Gynecology: What Physicians Should Know About Genetic Testing, Screening, and Risk Reduction x
OBSTETRICS AND GYNECOLOGY CLINICS\r xi
FORTHCOMING ISSUES xi
June 2018 xi
September 2018 xi
December 2018 xi
RECENT ISSUES xi
December 2017 xi
September 2017 xi
June 2017 xi
Foreword: Update on Reproductive Genetics: What an Obstetrician-Gynecologist Needs to Know\r xiii
Preface:\rReproductive Genetics xv
Genetic Counseling Overview for the Obstetrician-Gynecologist 1
Key points 1
INTRODUCTION 1
DEFINITION OF GENETIC COUNSELING 3
Risk Assessment 3
Genetic Testing 4
Pretest Counseling 5
Posttest Counseling 6
Support 7
GENETIC COUNSELING IN CLINICAL PRACTICE 8
Genetic Counseling Models 9
Collaborative Care 10
SUMMARY 10
REFERENCES 11
Cell-Free DNA Screening for Aneuploidy and Microdeletion Syndromes 13
Key points 13
INTRODUCTION 13
DNA AND HOW IS IT USED FOR SCREENING? 14
DNA SCREENING FOR COMMON AUTOSOMAL TRISOMIES 15
Trisomy 21 15
Trisomies 13 and 18 16
Monosomy X (Turner Syndrome) 16
Other Sex Chromosome Aneuploidies 16
CHROMOSOMAL MICRODELETIONS 17
DNA CONTRIBUTION, OR FETAL FRACTION 17
FALSE POSITIVES AND INCIDENTAL FINDINGS 18
PRETEST COUNSELING 19
INDICATIONS FOR CFDNA SCREENING 21
DNA TO TRADITIONAL SCREENING 21
CELL-FREE DNA IN THE OVERALL CONTEXT OF ALL CONGENITAL DISORDERS 22
SUMMARY 23
REFERENCES 23
Cell-Free DNA 27
Key points 27
INTRODUCTION 27
CELL-FREE DNA 28
Screening Technology and Reporting 28
Limitations of Cell-Free DNA 29
SINGLE-GENE DISORDERS 29
AUTOSOMAL DOMINANT DISORDERS 31
X-LINKED AND AUTOSOMAL RECESSIVE CONDITIONS 32
RELATIVE MUTATION DOSING AND EVOLVING TECHNOLOGIES 32
FETAL BLOOD GROUP SYSTEM 33
Rhesus D Genotyping 33
Additional Blood Group Systems 34
SUMMARY 34
REFERENCES 34
Screening for Aneuploidy in Multiple Gestations 41
Key points 41
INTRODUCTION 41
FACTORS ASSOCIATED WITH ANEUPLOIDY IN TWIN GESTATIONS 42
Zygosity 42
Monozygotic twins 42
Dizygotic twins 42
Maternal Age 43
SCREENING METHODS 43
Ultrasonography 43
Nuchal translucency 43
Nasal bone 44
Biochemical Screening 44
First-trimester biochemical screening 44
First-trimester biochemical screening and nuchal translucency 44
Second-trimester biochemical screening 46
First and second-trimester integrated screening 47
Biochemical Screening Summary 47
CELL-FREE DNA SCREENING 47
HIGHER-ORDER MULTIPLES 49
SUMMARY 49
REFERENCES 50
The Use of Chromosomal Microarray Analysis in Prenatal Diagnosis 55
Key points 55
INTRODUCTION 55
CHROMOSOMAL MICROARRAY TECHNOLOGY 56
Oligonucleotide Array Comparative Genomic Hybridization Versus Single Nucleotide Polymorphism Microarray 56
Targeted Versus Whole Genome Arrays 58
CHROMOSOMAL MICROARRAY ANALYSIS REPORTING 58
THE ROLE OF CHROMOSOMAL MICROARRAY ANALYSIS IN PRENATAL DIAGNOSIS 61
Chromosomal Microarray Analysis Versus Karyotype 61
Chromosomal Microarray Analysis as Routine Testing 61
Chromosomal Microarray Analysis in Fetuses with Ultrasound Anomalies 63
Comparison of Diagnostic Testing Versus Screening for Prenatal Surveillance 63
Cell-Free DNA Screening and Microdeletions 64
COUNSELING CONSIDERATION 64
Pretest Counseling 65
Posttest Counseling 65
SUMMARY 66
REFERENCES 66
Whole Exome Sequencing 69
Key points 69
BACKGROUND 69
PRENATAL 70
Therapy 72
CLINICAL INDICATIONS 73
American College of Medical Genetics and Genomics Reportable Variants 73
INTERPRETATION/COUNSELING 74
LIMITATIONS 75
RESEARCH IMPLICATIONS 75
ETHICS 76
COSTS 76
FUTURE ADVANCES 77
REFERENCES 77
Ethnicity-Based Carrier Screening 83
Key points 83
INTRODUCTION 83
DISORDERS 86
Hemoglobinopathies 86
Sickle Cell Disorders 87
α-Thalassemia 88
β-Thalassemia 89
Ashkenazi Jewish Genetic Disorders 90
Tay-Sachs Disease 91
Canavan Disease 92
Cystic Fibrosis 92
Familial Dysautonomia 92
Fanconi Anemia Group C 92
Niemann-Pick Disease Type A 93
Bloom Syndrome 93
Mucolipidosis Type IV 93
Gaucher Disease 93
Cystic Fibrosis 94
Spinal Muscular Atrophy 94
Fragile X Syndrome 96
DISCUSSION 97
REFERENCES 98
Expanded Carrier Screening 103
Key points 103
SCREENING 103
HISTORICAL PERSPECTIVE 105
PURPOSE 106
CARRIER FREQUENCY AND RESIDUAL RISK 107
VARIANTS AND CONDITIONS 108
IMPLEMENTING EXPANDED CARRIER SCREENING 108
Advantages and Disadvantages 109
Counseling 109
Pretest and Posttest Counseling 110
SUMMARY 111
REFERENCES 111
Preimplantation Genetic Screening and Preimplantation Genetic Diagnosis 113
Key points 113
INTRODUCTION 113
BIOPSY TECHNIQUES 115
Polar Body Biopsy 115
Cleavage Stage (Blastomere) Biopsy 115
Trophectoderm Biopsy 115
PREIMPLANTATION GENETIC SCREENING 116
PREIMPLANTATION GENETIC SCREENING PLATFORMS 116
Array Comparative Genomic Hybridization Microarray 116
Single Nucleotide Polymorphism Microarray 118
Quantitative Polymerase Chain Reaction 118
Next-Generation Sequencing 118
PREGNANCY RATES AFTER PREIMPLANTATION GENETIC SCREENING 119
PREIMPLANTATION GENETIC DIAGNOSIS 120
Early Indications 120
Single Gene Disorders and Karyomapping 120
ETHICAL CONSIDERATIONS 120
SUMMARY 122
REFERENCES 122
Key Ethical Issues in Prenatal Genetics 127
Key points 127
INTRODUCTION 127
CHALLENGES INHERENT WITH GENETIC TESTING IN UTERO 128
TECHNOLOGICAL CONSIDERATIONS: IN THEORY AND IN REALITY 129
Actionability 130
Severity 130
Age of Onset 131
Parental Autonomy 131
Access and Regulatory Factors 132
CLINICAL CONSIDERATIONS: INFORMED DECISION MAKING AND CONSENT 133
ACCESS TO CARE 134
SUMMARY 136
REFERENCES 136
The Status of Genetic Screening in Recurrent Pregnancy Loss 143
Key points 143
INTRODUCTION 143
OVERVIEW OF THE GENETIC CAUSES OF RECURRENT PREGNANCY LOSS 144
Numerical Chromosomal Abnormalities 145
Structural Chromosomal Abnormalities 146
Translocations 147
Inversions 149
Other rearrangements 149
Single Nucleotide Polymorphisms and Copy Number Variants Associated with Recurrent Pregnancy Loss 149
EVALUATION OF PRODUCTS OF CONCEPTION 150
MANAGEMENT OPTIONS FOR GENETIC CAUSES OF RECURRENT PREGNANCY LOSS 151
SUMMARY 152
REFERENCES 152
Hereditary Cancers in Gynecology 155
Key points 155
INTRODUCTION 155
HEREDITARY CANCER SYNDROMES 156
Hereditary Breast and Ovarian Cancer 156
Hereditary Ovarian Cancer 157
Lynch Syndrome 157
Polymerase Proofreading Associated Polyposis 157
Cowden Syndrome 160
Peutz-Jeghers Syndrome 160
Li-Fraumeni Syndrome 161
IDENTIFICATION OF HIGH-RISK WOMEN 161
SCREENING STRATEGIES 164
Breast Cancer Screening 164
Ovarian Cancer Screening 166
Endometrial Cancer Screening 167
Cervical Cancer Screening 167
RISK-REDUCTION STRATEGIES 167
Hereditary Breast and Ovarian Cancer 167
Hereditary Ovarian Cancer 168
Lynch Syndrome 169
Polymerase Proofreading Associated Polyposis 169
Cowden Syndrome 169
Peutz-Jeghers Syndrome 169
Li-Fraumeni Syndrome 169
SUMMARY 169
REFERENCES 170