Prenatal Diagnosis
John H. DiLiberti MD1
Mark A. Greenstein MD2
Sally Shulman Rosengren MD3
1 Chairman of Pediatrics and Medical Director, Tod Children's Hospital, Youngstown, OH; Professor of Pediatrics, Northeastern Ohio Universities College of Medicine, Rootstown, OH.
2 Attending Pediatrician, Department of Pediatrics, Saint Francis Hospital and Medical Center, Hartford, CT; Associate Professor, Division of Medical Genetics and Department of Pediatrics, University of Connecticut Health Center, Farmington, CT.
3 Assistant Attending Pediatrician, Department of Pediatrics, Saint Francis Hospital and Medical Center, Hartford, CT; Assistant Professor, Division of Medical Genetics and Department of Pediatrics, University of Connecticut Health Center, Farmington, CT.
The enormous progress witnessed in the field of prenatal diagnosis during the past two decades is likely to continue into the future. Improved imaging techniques are likely to enhance the resolution of noninvasively obtained fetal images considerably over their current excellent quality. Although this undoubtedly will be true for ultrasonography, the increased speed of magnetic resonance equipment may offer a new realm of imaging possibilities. Computerized image processing, analysis, and three-dimensional reconstructions all should make interpretation of fetal images easier and more understandable to the nonspecialist. Advances in molecular genetics will continue to accelerate, greatly expanding the range and accuracy of prenatal diagnosis.
The alert pediatrician who is sensitive to genetic issues may, by early detection of pediatric disorders and careful family history assessment, be in a position to identify families at risk for serious genetic conditions and provide the opportunity to make informed decisions on reproductive options that avert a major tragedy. The pediatrician, working with obstetric colleagues, should be part of a team effort to support families going through prenatal testing. Familiarity with these rapidly changing technologies will make it far easier to support the family needing additional explanation about prenatal diagnosis issues.
