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At the Heart of the Pregnancy: What Prenatal and Cardiovascular Genetic Counselors Need to Know about Maternal Heart Disease

  • Review Paper
  • Published:
Journal of Genetic Counseling

An Erratum to this article was published on 04 May 2017

Abstract

In the last decade, an increasing number of cardiac conditions have been shown to have a genetic basis. Cardiovascular genetic counseling has emerged as a subspecialty aiming to identify unaffected at-risk individuals. An important sector of this at-risk population also includes expectant mothers, in whom unique clinical challenges may arise. Genetic counselors, especially those in cardiovascular and prenatal settings, have an opportunity to identify and assist women who may benefit from cardiovascular care during pregnancy. This paper provides basic management and genetic evaluation principles for affected women, as well as guidance on identifying those who are at risk. We provide considerations for cardiac surveillance in pregnancy and the post-partum period. Finally, key psychosocial issues that appraise how to best provide support to at risk women as they make informed decisions are discussed. We propose that a team approach including cardiology, maternal fetal medicine, and genetic counseling best serves this patient population. Ongoing questions addressing an evidence based approach to cardiovascular genetic conditions in pregnancy still remain. Thus, well-designed research protocols are essential to mark progress in this area.

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Authors and Affiliations

  1. Department of Internal Medicine, The Ohio State University, Columbus, OH, USA

    Ana Morales & Dawn C. Allain

  2. Human Genetics Division, The Ohio State University, 306 BRT, 460 W. 12th Ave, Columbus, OH, 43210, USA

    Ana Morales & Dawn C. Allain

  3. Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA

    Patricia Arscott

  4. Allegheny General Hospital, Pittsburgh, PA, USA

    Emily James

  5. Institute of Genetic Medicine, Johns Hopkins University, Baltimore, MD, USA

    Gretchen MacCarrick

  6. Division of Cardiology, Johns Hopkins University, Baltimore, MD, USA

    Brittney Murray, Crystal Tichnell & Harikrishna S. Tandri

  7. Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Amy R. Shikany

  8. Department of Obstetrics and Gynecology, Northwestern Medicine, Chicago, IL, USA

    Sara Spencer

  9. The Heart Center, Nationwide Children’s Hospital, Columbus, OH, USA

    Sara M. Fitzgerald-Butt

  10. Oregon Health and Science University, Portland, OR, USA

    Jessica D. Kushner

  11. GeneDx, Gaithersburg, MD, USA

    Christi Munn

  12. Cardiovascular Genetics Program, Yale School of Medicine, New Haven, CT, USA

    Emily Smith

  13. Department of Medicine, Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, IN, USA

    Katherine G. Spoonamore & W. Aaron Kay

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  1. Ana Morales
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  2. Dawn C. Allain
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  15. Harikrishna S. Tandri
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  16. W. Aaron Kay
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Corresponding author

Correspondence to Ana Morales.

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Conflict of Interest

Ana Morales, MS, CGC - none.

Dawn C. Allain, MS, CGC - none.

Patricia Arscott, MS, CGC - none.

Emily James MS, CGC - none.

Gretchen MacCarrick, MS, CGC - none.

Brittney Murray, MS, CGC - none.

Crystal Tichnell, MGC - none.

Amy R. Shikany, MS, CGC – Consultant, Omicia, Inc.

Sara Spencer, MS, CGC - none.

Sara M. Fitzgerald-Butt, MS, CGC - Cardio Advisory Board, Invitae.

Jessica D. Kushner, MS, CGC - none.

Christi Munn, MS, CGC - Employed by Bioreference Laboratories/GeneDx.

Emily Smith, MS, CGC - none.

Katherine G. Spoonamore, MS, CGC - Cardio Advisory Board, Invitae.

Harikrishna S. Tandri, MD - none.

W. Aaron Kay, MD - none.

Additional information

An erratum to this article is available at http://dx.doi.org/10.1007/s10897-017-0101-z.

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Morales, A., Allain, D.C., Arscott, P. et al. At the Heart of the Pregnancy: What Prenatal and Cardiovascular Genetic Counselors Need to Know about Maternal Heart Disease. J Genet Counsel 26, 669–688 (2017). https://doi.org/10.1007/s10897-017-0081-z

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  • DOI: https://doi.org/10.1007/s10897-017-0081-z

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