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    Indications for Genetic Counseling

    and/or Education In Obstetric Practice

    1. Recurrent pregnancy loss/stillbirth.
    2. Couples of "advanced age" (females over 35 and/or males over 55) who are considering pregnancy or expecting.
    3. Primary amenorrhea, aspermia, infertility or abnormal sexual development.
    4. Previous history or family history of children with multiple malformations and/or mental retardation.
    5. Known familial chromosomal abnormality.
    6. Common birth defects (cleft lip/palate, neural tube defects, multiple vertebral anomalies, congenital heart disease, clubfoot, dislocated hips, etc.).
    7. Elevated maternal serum alpha fetoprotein.
    8. Couples in which the spouses are related.
    9. Couples with an ethnic background suggesting a high risk for any disorder (Jewish couples for Tay-Sachs screening, Black/Mediterranean couples with positive screens for a sickle hemoglobinopathy or thalessemia, etc.).
    10. Woman exposed to potential teratogens - radiation; chemicals; certain medications (anticonvulsants, anticoagulants, antimetabolites, thyroid antagonists, steroids, etc.); recreational drugs (including alcohol); certain viral agents; very high fevers, etc.
    11. Women considering pregnancy who themselves have a hereditary disorder even though treated and clinically normal (PKU, homocystinuria, etc.).
    12. Families with known hereditary conditions and/or questions about recurrence risks.
    13. History of any disease "running in the family," especially hearing loss; blindness; neurodegenerative disorders; short stature; premature heart disease; immune deficiency; abnormalities of the hair, skin or bones; or mental retardation.
    14. Couples with questions about prenatal diagnosis for any disorder.