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Genetics and Prenatal Screening Genetics • Each human cell contains 46 chromosomes made up of DNA. Short segments of DNA are called “genes” Dominant and Recessive Genes • • – When one is “dominant” then that expression “trumps” the recessive gene. • • Carriers? Table 3.2- Dark Hair/Blond, Curly/Straight, Dimples/no dimples, double-jointed/normal joints Chromosome and Genelinked Abnormalities • Chromosome Abnormalities – Down syndrome- trisomy 21 • • round face, flattened skull, extra skin over the eyelids, protruding tongue, short limbs, and motor and mental retardation. 1/1900 @ 20 years; 1/45 @ 42 years Chromosome and Genelinked Abnormalities • Chromosome Abnormalities – Down syndrome- trisomy 21 • • – round face, flattened skull, extra skin over the eyelids, protruding tongue, short limbs, and motor and mental retardation. 1/1900 @ 20 years; 1/45 @ 42 years Fragile X- Problem with the X-chromosome: often breaks • • • typically mental retardation more frequent in males. Why? 1/250 females are carriers vs. 1/800 males Chromosome and Genelinked Abnormalities • Genetic Abnormalities – PKU- Phenylketonuria- Cannot properly metabolize the substance (phenylalanine). • • – mental retardation and hyperactivity if untreated. “Curable” -Nature/nurture Sickle-cell anemia- Deforms the body’s red blood cells • • • • • cells die causing anemia Early death if left untreated.- Penicillin 1/400 Af-Am babies born with <1/10 Af-Am are carriers 1/5 Africans Prenatal Screening • Dangerous- Why get it? – <3% of preg genetic abnormalities • – – – 20% of infant deaths Parents have family history of disease? Is mom/dad carrier? (Dominant”) Does mother have any diseases? CMV-Cytomegalovirus Are parents carries of a recessive sickle cell allele Prenatal Screening • Family History – – – – – – Blood relatives with disorders History of previous miscarriages Children with specific genetic disorders Members of at-risk group Mother’s age and Father’s age Behavior- Do parents use drugs/alcohol Prenatal detection • HCG-Human Chorionic Gonadotropin- Blood test- similar to a typical pregnancy test – – Can determine an ectopic pregnancy Sometimes combined with…. Prenatal Detection • AFP- Alpha-fetoprotein- (also a Blood test) – – – – – looking for AFP being produced amniotic fluid and mothers blood. Done at 15-20 weeks Can determine if child has Down Syndrome (Decreased Levels)- though only in about 60% of cases Can “help” determine neural tube defects such as spina bifida (Increased levels) Fetal distress Prenatal Detection • Ultrasound- Standard of Care – – – Done at about 20-22 weeks 2-D image using sound waves Considered low-risk as long as nonrepeated exposure- possible low birth weight – Doppler Ultrasound- 1 hour sessionColor- Can look for signs of preeclampsia, poor blood flow. Other ultrasounds • http://www.youtube.com/watch?v=uo 5gOWzgoaY • 4-D ultrasound Prenatal Detection • Amniocentesis – Done between 16th and 18th week though used to be done at 20th-22nd week. • – – – – – Why the change???? Takes two weeks to month to get results. Needle through stomach, uterine wall, and amniotic sac, remove small amt of fluid Avg. range=.3-.5%, but as high as 3-8% fetal loss Risk of loss is greater than risk of birth defects in older moms Can detect several hundred diff birth defects (out of 4000) Prenatal Detection • CVS- Chorionic Villi Sampling – – – – – – Done at 10-12 weeks Results take less than 10 days Using ultrasound, take fetal cells from the chorion (placenta) between a 0.5% and 1% risk of miscarriage Slightly higher risk than amnio Possible birth defects (1/3000)