Early detection of chromosomal abnormalities in pregnancy can help patients and their providers navigate pregnancy options or expected outcomes. Identification of pregnancies at high risk of a congenital anomaly or chromosomal abnormality can benefit families by facilitating the referral and involvement of a multidisciplinary team to review options, manage expectations, and reduce morbidity and mortality of affected neonates. This module provides an overview of prenatal screening options currently available in Newfoundland and Labrador. It will review indications, timing, interpretation of results, and appropriate referral processes. 

After completing this online learning module, you will be able to:

1. Describe the prenatal screening tests offered to patients in Newfoundland and Labrador, their respective specificity, and sensitivity.
2. Summarize the physiology of cell free fetal DNA and the mechanism of this testing.
3. Identify the appropriate gestational periods for conducting each prenatal screening test.
4. Outline the relative costs of the various screening modalities, suppliers, and the appropriate requisition process for each.
5. List helpful tips on counselling patients around their decision to proceed with, or decline, prenatal screening tests.
6. Identify prenatal screening modalities available to multiple gestation pregnancies.
7. Interpret high and low risk (ie. positive and negative) test results and discuss the appropriate next steps to take when a prenatal screening test suggests a positive, or high-risk result.
8. Review strategies for having difficult conversations with patients in the context of prenatal screening.
9. Review barriers to offering prenatal screening and provide suggestions on how to overcome these barriers in the clinical setting. 

This continuing professional development (CPD) program is designed to consider the CanMEDS Family Medicine 2017 Physician Competency Framework, including the roles of:

• Medical Expert
• Communicator

Subject Matter Expert

• Nicole MacEachren MD FRCSC OBGYN

Planning Committee

• Katie Bennett MD CCFP
• Taylor Anderson MD CCFP
• Nicole MacEachren MD
• Krisztina Bajzak MD FRCSC
• Keisha Clarke NP

---