The National Academy of Clinical Biochemistry
Laboratory Medicine Practice Guidelines

Draft Guidelines
Version 2

Maternal and Fetal Health Risk Assessment

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This laboratory medicine guideline was developed beginning with preconception issues and proceeding through pregnancy identification, first and second trimester evaluation of fetal health, to delivery and initial evaluation of the newborn. While we have attempted to define the central laboratory medicine issues, this is not a comprehensive listing of all possible events or the medical evaluation that may be required. Our recommendations are based upon the consensus of expert contributors and their experience in their field of expertise. Some issues are not yet fully resolved, and may require us to revisit this topic at some future date. The dietary addition of folic acid has had a significant effect on the incidence of neural tube defects, and we may see some continuation of this trend. The emerging role of first trimester screening for fetal health will continue to develop, and there is some suggestion that it may supplant at least a portion of second trimester screening. The evaluation of the high risk infant at term continues to increase in complexity as does the evaluation of the newborn infant. For this reason we welcome your comments and suggestions. Please send them to John Sherwin at jsherwin@dhs.ca.gov.

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Reproduced (translated) with permission of the National Academy of Clinical Biochemistry, Washington, DC.

Organizing Committee and Editors:

John E. Sherwin
Chair, Genetic Disease Laboratory
State of California, Berkeley, CA 94710

Edward Ashwood
ARUP Laboratories/University of Utah
Salt Lake City, UT 84108

Sharon Geaghan

Carol Lee
Immunoassay New Product Manager
Systems Technical Support, Beckman Coulter, Inc.
Chaska, MN 55318

Gillian Lockitch
Department of Pathology & Laboratory Medicine
Children's & Women's Health Centre of BC
Vancouver, BC, Canada, V6H 3V4

John Sherwin, Ph.D.
Chief, Genetic Disease Laboratory
State of California, Berkeley, CA 94710