医学遗传学-20遗传咨询课件.pptx

1、Medical GeneticsGenetic counseling is the process evaluating family history and medical records ordering genetic tests evaluating the results of this investigation helping parents understand and reach decisions about what to do nextMedical Genetics Genetic tests are done by analyzing small samples o

2、f blood or body tissues.They determine whether you,your partner,or your baby carry genes for certain inherited disorders.Medical Genetics Genetic counselors are health professionals with specialized graduate degrees and experience in the areas of medical genetics and counseling.Medical Genetics Most

3、 enter the field from a variety of disciplines,including biology,genetics,nursing,psychology,public health and social work.Medical Genetics Genetic counselors work as members of a healthcare team,providing information and support to families who have members with birth defects or genetic disorders a

4、nd to families who may be at risk for a variety of inherited conditions.Medical Genetics They identify families at risk,investigate the problem present in the family,interpret information about the disorder,analyze inheritance patterns and risks of recurrence,and review available options with the fa

5、mily.Medical Genetics Genetic counselors also provide supportive counseling to families,serve as patient advocates,and refer individuals and families to community or state support services.Medical Genetics They serve as educators and resource people for other healthcare professionals and for the gen

6、eral public.Medical Genetics Some counselors also work in administrative capacities.Many engage in research activities related to the field of medical genetics and genetic counseling.Medical Genetics Most couples planning a pregnancy or who are expecting dont need genetic counseling.Medical Genetics

7、 About 3%of babies are born with birth defects each year,according to the U.S.Centers for Disease Control and Prevention-and of the malformations that do occur,the most common are also among the most treatable.Medical Genetics Cleft palate and clubfoot,two of the more common birth defects,can be sur

8、gically repaired,as can many heart malformations.Medical Genetics The best time to seek genetic counseling is before becoming pregnant,when a counselor can help assess your risk factors.But even after he become pregnant,a meeting with a genetic counselor can still be helpful.Medical Genetics For exa

9、mple,several babies have been diagnosed with spina bifida before birth.Recent research suggests that delivering a baby with spina bifida via cesarean section can minimize damage to the babys spine-and perhaps reduce the likelihood that the child will need a wheelchair.Medical Genetics You should con

10、sider genetic counseling if any of the following risk factors apply to you:(1)if a standard prenatal screening test(such as the alpha fetoprotein test)yields an abnormal result(2)if an amniocentesis yields an unexpected result(such as a chromosomal defect in the unborn baby)Medical Genetics(3)if eit

11、her parent or a close relative has an inherited disease or birth defect(4)if either parent or a close relative has an inherited disease or birth defect(5)if either parent already has children with birth defects or genetic disorders Medical Genetics(6)if the mother-to-be has had two or more miscarria

12、ges or babies that died in infancy(7)if the mother-to-be will be 35 or older when the baby is bornMedical Genetics Chances of having a child with Down syndrome increase with the mothers age:a 35-year-old woman has a one in 350 chance of conceiving a child with Down syndrome.This chance increases to

13、one in 110 by age 40 and one in 30 by age 45.Medical Genetics(8)if parents are concerned about genetic defects that occur frequently in their ethnic or racial groupMedical Genetics For example,couples of African descent are most at risk for having a child with sickle cell anemia;couples of central o

14、r eastern European Jewish(Ashekenazi),Cajun,or Irish descent may be carriers of Tay-Sachs disease;and couples of Italian,Greek,or Middle Eastern descent may carry the gene for thalassemia,a red blood cell disorder.Medical Genetics Before he meet with a genetic counselor in person,youll be asked to g

15、ather information about his family history.Medical Genetics The counselor will want to know of any relatives with genetic disorders,multiple miscarriages,and early or unexplained deaths.Medical Genetics The counselor will also want to look over his medical records,including any ultrasounds,prenatal

16、test results,past pregnancies,and medications he may have taken before or during pregnancy.Medical Genetics If more tests are necessary,the counselor will help him set up those appointments and track the paperwork.When the results come in,the counselor will call him with the news.Often,the counselor

17、 will encourage him to come in for a discussion.Medical Genetics The counselor will study his records before meeting with him,so he can make the best use of his time together.During his session,he or she will go over any gaps or potential problem areas in his family or medical history.Medical Geneti

18、cs The counselor can then help him understand the inheritance patterns of any potential disorders and help assess his chances of having a child with those disorders.Medical Genetics He or she will distinguish between risks that every pregnancy faces and risks that he personally faces.Even if he disc

19、overs he has a particular problem gene,science cant always predict the severity of the related disease.For instance,a child with cystic fibrosis can have debilitating lung problems or,less commonly,milder respiratory symptoms.Medical Genetics He and his family will have to decide what to do next.Gen

20、etic counselors help him to understand his options and adjust to the difficulties and uncertainties he faces.Medical Genetics If he has learned prior to conception that he and/or his partner are at high risk for having a child with a severe or fatal defect,his options might include:pre-implantation

21、diagnosis using donor sperm or donor eggs adoptionMedical Genetics If he has received a prenatal diagnosis of a severe or fatal defect,his options might include:preparing himself for the challenges youll face when he have your baby fetal surgery to repair the defect before birth ending the pregnancy

22、 Medical Genetics For some families,knowing that theyll have an infant with a severe or fatal genetic condition seems too much to bear.Other families are able to adapt to the news-and to the birth-remarkably well.Medical Genetics Genetic counselors can share the experiences theyve had with other fam

23、ilies in your situation.But they will not suggest a particular course of action.Medical Genetics A good genetic counselor understands that what is right for one family may not be right for another.Medical Genetics Genetic counselors can,however,refer he to specialists for further help.For instance,m

24、any babies with Down syndrome are born with heart defects.Medical Genetics The counselor might encourage him to meet with a cardiologist to discuss heart surgery,and a neonatologist to discuss the care of a post-operative newborn.Medical Genetics Genetic counselors can also refer he to social workers,support groups,or mental health professionals to help he adjust to and prepare for your complex new reality.