Genetic Counseling for Teratogen Exposure

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Abstract
A consecutive series of 200 patients referred for genetic counseling after teratogen exposure was evaluated. One hundred four patients (52%) has exposure to more than one potentially teratogenic agent. One-third of the patients had a positive family history for genetic disease and 10% were of advanced maternal age. Genetic counseling was altered for the majority of patients when all risk factors (age, family history, and multiple teratogen exposure) were considered. Failure to evaluate all aspects of potential risk results in incomplete counseling. The majority of patients (97%) elected to continue their pregnancies after complete counseling. Three of five pregnancy terminations resulted from exposure to documented human teratogens. Precise risk assessment for the teratogen-exposed patient requires thorough genetic counseling to maximize successful pregnancy outcome.