This activity is intended for healthcare providers delivering care to women and their families.
After completing this activity, the participant should be better able to:
1. List the benefits and limitations of microarray technology
2. Discuss professional guidelines on the use of microarrays in the prenatal and postnatal period
Estimated time to complete activity: 0.25 hours
Susan J. Gross, MD, FRCSC, FACOG, FACMG
President and CEO, The ObG Project
Postgraduate Institute for Medicine (PIM) requires faculty, planners, and others in control of educational content to disclose all their financial relationships with ineligible companies. All identified conflicts of interest (COI) are thoroughly vetted and mitigated according to PIM policy. PIM is committed to providing its learners with high quality accredited continuing education activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of an ineligible company.
The PIM planners and others have nothing to disclose. The OBG Project planners and others have nothing to disclose.
Faculty: Susan J. Gross, MD, receives consulting fees from Cradle Genomics, and has financial interest in The ObG Project, Inc.
Planners and Managers: The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose.
Fees for participating and receiving CME credit for this activity are as posted on The ObG Project website. During the period from Dec 31 2017 through Jan 25 2023, participants must read the learning objectives and faculty disclosures and study the educational activity.
If you wish to receive acknowledgment for completing this activity, please complete the test and evaluation. Upon registering and successfully completing the test with a score of 100% and the activity evaluation, your certificate will be made available immediately.
In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and The ObG Project. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Postgraduate Institute for Medicine designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The maximum number of hours awarded for this Continuing Nursing Education activity is 0.2 contact hours.
Chromosomal microarray (also known as CMA) technology has revolutionized the practice of genetics and is now commonly ordered prenatally and throughout the lifespan. Structural chromosomal anomalies, once too small to be ‘seen’ using conventional karyotyping, can now be detected using molecular techniques. Microarrays can detect copy number variants (CNVs) and therefore identify chromosomal regions where there is excess DNA (a duplication) or missing DNA (a deletion).
Consider the following when counseling:
Prenatal detection of clinically significant CNVs that would have been missed using conventional karyotyping alone
Postnatal detection of significant CNVs that would have been missed using conventional karyotyping alone
Can be performed on tissue that is no longer viable
Single gene disorders
Variants of uncertain significance (VUS)
The data from a major NICHD study in 2012 provided the support for introducing microarray technology into prenatal clinical care, with previous studies highlighting the benefits in the postnatal period and beyond. Similar to a conventional karyotype, microarrays can detect aneuplodies and larger structural chromosomal changes. In addition, microarray technology allows for the identification of small duplications and microdeletions that would otherwise go unreported. There are limitations and expert counseling is required to provide optimal care and informed decision making.
SOGC & CCMG
NOTE: Professional bodies universally recommend expert pre- and post-test counseling whenever microarray is being considered
Want to hear about the latest clinical summaries?
ACOG/ SMFM Committee Opinion 682: Microarrays and Next-Generation Sequencing Technology: The Use of Advanced Genetic Diagnostic Tools in Obstetrics and Gynecology
SMFM: The use of chromosomal microarray for prenatal diagnosis
ACMG Standards and Guidelines for constitutional cytogenomic microarray analysis, including postnatal and prenatal applications: revision 2013
Yield of additional genetic testing after chromosomal microarray for diagnosis of neurodevelopmental disability and congenital anomalies: a clinical practice resource of the American College of Medical Genetics and Genomics (ACMG 2018)
Practice guideline: joint CCMG-SOGC recommendations for the use of chromosomal microarray analysis for prenatal diagnosis and assessment of fetal loss in Canada
NEJM (2012): Chromosomal Microarray versus Karyotyping for Prenatal Diagnosis
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presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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