title: Offering Prenatal Screening in the Age of Genomic Medicine: A Practical Guide.
abstract: In September, 2015, Mayo Clinic convened a panel of national thought leaders on prenatal screening, medical genetics, and obstetrics and gynecology practice.
  
  
  
  During the 2-day symposium, participants discussed the implications of the shift toward broader prenatal screening using cell-free placental DNA in maternal serum (cfDNA screening). Key topics included challenges around the pace of change in the prenatal screening market, uncertainty around reimbursement, meeting the need for patient counseling, and potential challenges in interpreting and returning cfDNA screening results.
  
  
  
  Here, we describe the challenges discussed and offer clinical recommendations for practices who are working to meet them.
  
  
  
  As the spread of prenatal genetic screening continues, providers will increasingly need to update their practice to accommodate new screening modalities.
authors.affiliation: 1 Biomedical Ethics Program, Mayo Clinic , Rochester, Minnesota.
authors.forename: Megan
authors.initials: M
authors.lastname: Allyse
authors.affiliation: 2 Department of Laboratory Medicine and Pathology, Mayo Clinic , Rochester, Minnesota.
authors.forename: Umut
authors.initials: U
authors.lastname: Aypar
authors.affiliation: 3 Expecting Health, Genetic Alliance , Washington, District of Columbia.
authors.forename: Natasha
authors.initials: N
authors.lastname: Bonhomme
authors.affiliation: 4 Department of Molecular and Human Genetics, Baylor College of Medicine , Houston, Texas.
authors.forename: Sandra
authors.initials: S
authors.lastname: Darilek
authors.affiliation: 5 American Society of Human Genetics, Department of Pediatrics, University of Colorado School of Medicine , Aurora, Colorado.
authors.forename: Michael
authors.initials: M
authors.lastname: Dougherty
authors.affiliation: 6 Department of Obstetrics and Gynecology, Cleveland Clinic , Cleveland, Ohio.
authors.forename: Ruth
authors.initials: R
authors.lastname: Farrell
authors.affiliation: 7 Divisions of Medical Genetics and Molecular Diagnostics, Departments of Pathology and Laboratory Medicine, Pediatrics, and Human Genetics, UCLA School of Medicine , Los Angeles, California.
authors.forename: Wayne
authors.initials: W
authors.lastname: Grody
authors.affiliation: 2 Department of Laboratory Medicine and Pathology, Mayo Clinic , Rochester, Minnesota.
authors.forename: W Edward
authors.initials: WE
authors.lastname: Highsmith
authors.affiliation: 8 Institute for Health and Aging, University of California , San Francisco, San Francisco, California.
authors.forename: Marsha
authors.initials: M
authors.lastname: Michie
authors.affiliation: 9 Department of Pediatrics, University of California , San Diego, San Diego, California.|10 Department of Medical Genetics, Kaiser Permanente , San Diego, San Diego, California.
authors.forename: Mark
authors.initials: M
authors.lastname: Nunes
authors.affiliation: 11 Department of Obstetrics and Gynecology, Mayo Clinic , Rochester, Minnesota.
authors.forename: Laura
authors.initials: L
authors.lastname: Otto
authors.affiliation: 12 Department of Obstetrics and Gynecology, Gundersen Health System , La Crosse, Wisconsin.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Pabst
authors.affiliation: 13 Department of Pathology and Laboratory Medicine, Women and Infants Hospital, Alpert Medical School, Brown University , Providence, Rhode Island.
authors.forename: Glenn
authors.initials: G
authors.lastname: Palomaki
authors.affiliation: 2 Department of Laboratory Medicine and Pathology, Mayo Clinic , Rochester, Minnesota.
authors.forename: Cassandra
authors.initials: C
authors.lastname: Runke
authors.affiliation: 1 Biomedical Ethics Program, Mayo Clinic , Rochester, Minnesota.
authors.forename: Richard R
authors.initials: RR
authors.lastname: Sharp
authors.affiliation: 14 Division of Medical Genetics, Department of Pediatrics, Massachusetts General Hospital , Boston, Massachusetts.|15 Department of Pediatrics, Harvard Medical School , Boston, Massachusetts.
authors.forename: Brian
authors.initials: B
authors.lastname: Skotko
authors.affiliation: 16 Genetic Support Foundation , Olympia, Washington.
authors.forename: Katie
authors.initials: K
authors.lastname: Stoll
authors.affiliation: 11 Department of Obstetrics and Gynecology, Mayo Clinic , Rochester, Minnesota.
authors.forename: Myra
authors.initials: M
authors.lastname: Wick
mesh_terms: D004247:DNA / Q000097:blood*; D005260:Female; D005817:Genetic Counseling; D005820:Genetic Testing / Q000379:methods*; D023281:Genomics; D006176:Gynecology; D006801:Humans; D009774:Obstetrics; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011296:Prenatal Diagnosis
chemical_list: D004247:DNA
keywords: genetic testing; prenatal care; prenatal counseling