Society of Obstetricians and Gynaecologists of Canada
Full Text Guideline
Evidence Supporting the Recommendations
The type of evidence supporting the recommendations is not specifically stated.
Implementation of the Guideline
An implementation strategy was not provided.
Benefits/Harms of Implementing the Guideline Recommendations
The benefits for the patient and her family include understanding of possible genetic risk and enhanced pregnancy outcomes.
The harms include increased anxiety or psychological stress associated with the possibility of identifying genetic risks.
Rating Scheme for the Strength of the Recommendations
This document reflects emerging clinical and scientific advances on the date issued and is subject to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed. Local institutions can dictate amendments to these opinions. They should be well documented if modified at the local level. None of these contents may be reproduced in any form without prior written permission of the Society of Obstetricians and Gynaecologists of Canada (SOGC).
Searches of Electronic Databases
Searches of Unpublished Data
PubMed or Medline and the Cochrane Database were searched in November 2009, using appropriate key words (preconception, genetic disease, maternal, family history, genetic health risk, genetic health surveillance, prenatal screening, prenatal diagnosis, birth defects, and teratogen). Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, and national and international medical specialty societies.
Expert Consensus (Committee)
A formal cost analysis was not performed and published cost analyses were not reviewed.
Internal Peer Review
This committee opinion has been prepared and reviewed by the Genetics Committee, reviewed by the MD Advisory Committee and the Medico-Legal Committee and approved by the Executive of the Society of Obstetricians and Gynaecologists of Canada.
Identifying Information and Availability
Wilson RD, Audibert F, Brock JA, Cartier L, Desilets VA, Gagnon A, Johnson JA, Langlois S, Murphy-Kaulbeck L, Okun N, Pastuck M. Genetic considerations for a woman's pre-conception evaluation. J Obstet Gynaecol Can. 2011 Jan;33(1):57-64. [31 references] PubMed
Not applicable: The guideline was not adapted from another source.
Society of Obstetricians and Gynaecologists of Canada
Principal Author: R. Douglas Wilson, MD, Calgary AB
Genetics Committee Members: R. Douglas Wilson, MD (Chair), Calgary AB; François Audibert, MD, Montreal QC; Jo-Ann Brock, MD, Halifax NS; Lola Cartier, MSc, Montreal QC; Valerie A. Désilets, MD, Montreal QC; Alain Gagnon, MD, Vancouver BC; Jo-Ann Johnson, MD, Calgary AB; Sylvie Langlois, MD, Vancouver BC; Lynn Murphy-Kaulbeck, MD, Moncton NB; Nanette Okun, MD, Toronto ON; Melanie Pastuck, RN, Edmonton AB
Disclosure statements have been received from all members of the committee.
This is the current release of the guideline.
Electronic copies: Available in Portable Document Format (PDF) from the Society of Obstetricians and Gynaecologists (SOGC) of Canada Web site.
Print copies: Available from the Society of Obstetricians and Gynaecologists of Canada, La société des obstétriciens et gynécologues du Canada (SOGC) 780 promenade Echo Drive Ottawa, ON K1S 5R7 (Canada); Phone: 1-800-561-2416.
This NGC summary was completed by ECRI Institute on April 6, 2011. The information was verified by the guideline developer on May 10, 2011.
This NGC summary is based on the original guideline, which is subject to the guideline developer's copyright restrictions.
- Birth defects
- Genetic and congenital anomalies
Obstetrics and Gynecology
Advanced Practice Nurses
Allied Health Personnel
Health Care Providers
To give health care providers information about the genetic information that can be used as part of health surveillance for women undergoing a pre-conception evaluation for genetic risk assessment and possible genetic screening or testing
Women of reproductive age and their partners
Pre-conception evaluation for genetic risk assessment and possible genetic screening or testing
- Maternal, infant, and child health outcomes
- Risk of genetic and congenital anomalies
Recommendations and Summary Statements
A review of the current literature does not provide enough information for this committee opinion to present evidence-based recommendations.
Pre-conception planning is important but may not always be possible because some pregnancies are unintended. The reproductive risks must be considered at all patient interactions because personal situations change, and new discoveries can affect family histories. Primary prevention of genetic and congenital anomalies is the goal in reducing perinatal morbidity and mortality and enhancing healthy families. Health care providers should always ask patients of reproductive age "Are you considering a pregnancy or could you possibly become pregnant?"
|Table: Taking a Pre-Conception History for Assessment and Counselling|
A thorough pre-conception history identifies couples who are genetically at risk. When women and their partners are informed of the risks of having a baby with birth defects or a genetic disorder prior to pregnancy, they are then able to determine their options regarding a pregnancy (including contraception, artificial insemination, adoption, prenatal invasive testing, or chance).
Adapted from Public Health Agency of Canada. Family-centred maternity and newborn care: national guidelines. Chapter 3. Preconception care. Health Canada, 2005.
Institute of Medicine (IOM) National Healthcare Quality Report Categories
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