Genetic counseling and genetic services in obstetrics and gynecology: implications for educational goals and clinical practice.

Analysis of genetic counseling and antenatal diagnostic services offered by a genetics unit in a women's hospital was undertaken to identify genetic needs of the obstetrician-gynecologist. For similar reasons we tabulated findings derived from a genetic questionnaire administered routinely to obstetric registrants. Certain well-defined indications for genetic referral were identified, allowing specific educational objectives to be formulated. Potential chromosomal abnormalities constitute the most common indications for referral, particularly advance maternal age and repetitive abortions. A wide range of mendelian and polygenic/multifactorial disorders was encountered, albeit many individually rare. This suggests that the obstetrician-gynecologist should become familiar with principles of these modes of inheritance. However, educational objectives need not stress specific details of rare disorders but rather should emphasize the relatively few disorders that the obstetrician-gynecologist is likely to encounter. Realistic suggestions are offered to achieve these objectives.