Module 2 A Flashcards
When should a midwife or WHNP involve a genetic counselor in carrier screening?
We should consult or arrange for a patient to see a genetic counselor after carrier screening if one or both partners are carriers
o Why do we offer carrier screening?
- The purpose of carrier screening is to identify healthy persons who carry gene mutations associated with disease or dysfunction
- to provide individuals/couples with information that they can use to make reproductive decisions, based on their preferences and values
o Why is it preferable to offer carrier screening before pregnancy, rather than during pregnancy?
- So that individuals/couples who are carriers of inherited gene-mutation conditions can choose not to have biological children, adopting, conceiving spontaneously with or without prenatal diagnostic testing, or undergoing in vitro fertilization with pre-implantation genetic testing.
o When should a midwife or WHNP involve a genetic counselor in carrier screening?
- We should consult or arrange for a patient to see a genetic counselor after carrier screening if one or both partners are carriers
o How can we advance health equity in carrier screening?
- By advocating for equity in insurance coverage and privacy of genetic testing results
o How do ethnic-specific, pan-ethnic, and expanded screening approaches differ?
- Ethnic-specific: conditions considered to be common in the ethnic group with which the patient identifies; conditions identified through family history
- Pan-ethnic: Screens all patients for specific conditions, regardless of identified ethnic group or ancestry
- Screens for a large number of conditions simultaneously, without regard to ethnic group or ancestry
o In general, how does screening for gene conditions differ from screening for chromosome or fetal anatomical development conditions?
- How will you assess which vaccinations should be given preconceptual to each patient?
Which vaccinations are the highest priority to assess prior to pregnancy?
MMR
- Which history or physical exam findings will you need to consider to determine which lab tests you will order?
- Which infections are high-priority to screen for during a preconception visit and in which patients (given their risk factors)? What significance do those infections potentially have in an upcoming pregnancy?
- Which physical exam components are necessary during a preconception visit?
- Which elements of someone’s medical history (including mental health, infection history, social history, vaccination history, family and genetic history) are relevant for a future pregnancy?
All
- Which physical exam components are necessary during a preconception visit?
a. Elevated blood pressure
b. Higher body weight
c. Heart murmurs or extra heart sounds
d. Uterine fibroids
e. Spinal deformity
f. Pelvic injury or deformity