Prenatal diagnosis of Down syndrome SlideShare

prenatal diagnosis - SlideShar

  1. Candidates for invasive prenatal diagnosis • Maternal age : risk of having down syndrome and any aneuploidies increased with age from 35 years to 40 years by four folds comparing to the young age and 10 fold increased risk at the age of 40- 45 . BUT 70 percent of Down syndrome pregnancies are in women younger than 35 years. 44
  2. ation of the pregnancy. While this applies in most situations, there is cautious optimism that with the advent of gene therapy prenatal diagnosis will, in time, lead to effective treatment in utero. 64 58
  3. e how a baby's body forms during pregnancy and how the baby's body functions as it grows in the womb and after birth
  4. Down syndrome 1. What is Down Syndrome • DS is a naturally occurring chromosomal arrangement that has always been a part of the human condition, being universally present across racial, gender or socioeconomic lines, and affecting approximately 1 in 800 live births, although there is considerable variation worldwide
  5. ation of pregnancy or even adoption and artificial inse
  6. prenatal diagnosis: Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. If you continue browsing the site, you agree to the use of cookies on this website
  7. ation

INTRODUCTION. Down syndrome is the most common chromosomal condition in liveborns and the most common genetic cause of intellectual disability. 1-3 Prenatal screening tests for Down syndrome are noninvasive and provide an estimate of the risk of an affected pregnancy, while definitive prenatal diagnosis is made by karyotyping cultured fetal cells obtained via an invasive procedure such as. Results. The prevalence of diagnosed Down syndrome cases was 2.4%. Maternal age alone was indication for prenatal diagnosis in 47 cases (45.2%), increased first-/second-trimester biochemical screening test in 34 cases (21.7%), abnormal ultrasound examination in 69 cases (43.9%), positive familial history for chromosomal abnormalities in four cases, and high risk for trisomy 21 revealed by cell.

Down syndrome (trisomy 21) is the most commonly recognized genetic cause of mental retardation. The risk of trisomy 21 is directly related to maternal age. All forms of prenatal testing for Down. Download Citation | Prenatal diagnosis of Down syndrome | Down syndromes are the most commonly recognized genetic cause of mental retardation. The risk of trisomy 21 is directly related to. The noninvasive prenatal diagnosis of trisomy 21 (Down syndrome) is an actively researched area of prenatal medicine, as this is the most common aneuploidy compatible with life and a major cause of mental retardation. The isolation of intact fetal cells, and most importantly, the successful detection of fetal-origin nucleic acids (cell-free fetal DNA and RNA), in maternal plasma even from the. Although there are a number of prenatal screening options available, the prenatal diagnosis of Down syndrome continues to rely upon invasive testing by amniocentesis or chorionic villus sampling to evaluate the fetal karyotype. Interphase fluorescence in situ hybridization (FISH) can also be performed for a more rapid turnaround time to detect. Case 21. Down Syndrome: Offer of Prenatal Diagnosis Down Syndrome: Offer of Prenatal Diagnosis Posted 2-16-05 Key Points The likelihood of having a child with Down syndrome increases with maternal age. In addition, prenatal screening tests, using maternal serum and fetal ultrasound, are available to identify pregnancies in which the fetus ha

Screening for Down syndrome is offered as a routine part of prenatal care. Although screening tests can only identify your risk of carrying a baby with Down syndrome, they can help you make decisions about more-specific diagnostic tests. Screening tests include the first trimester combined test and the integrated screening test Down's syndrome can be diagnosed before birth (prenatally) or after birth (postnatally). Down's syndrome may be suspected shortly after birth because of the typical features that a baby with Down's syndrome may have. Diagnosis is confirmed by genetic tests to look at the appearance and number of chromosomes of the baby. This is essentially. The most common chromosomal disorder is trisomy 21 (Down syndrome), with an incidence of 1 per 800 live births. 4 Trisomy 13 and 18 can also result in live births, though with a significantly lower incidence. 2,4 Sex chromosome aneuploidies are less common than autosomal aneuploidies. 4 The only known viable monosomy is monosomy X (Turner. 11 Non Invasive Prenatal Diagnosis of Down Syndrome Dimitra Kappou 1, Eleftheria Papadopoulou 2 and Stavros Sifakis 1 1Department of Obstetrics & Gynecology, University Hospital of Heraklion, Crete 2Department of Pediatrics, University Hospital of Heraklion, Crete Greece 1. Introduction Down syndrome (trisomy 21), which has an incidenc e of 1 in 800 live births, is considered t Many of us are parents who also received a prenatal diagnosis of Down syndrome and we truly understand how difficult it is to hear that unexpected news. We are a safe place to turn to with your questions and you are invited to share your feelings with people here who understand. We pledge to you that we will reach out to you with compassion and.

In the U.S., numerous states have attempted to restrict prenatal testing for Down syndrome, spina bifida, or more generally, genetic abnormalities, through legislation. In 2016, the Missouri. INTRODUCTION. Early detection of pregnancies at high risk for trisomy 21 (Down syndrome) is the primary target of prenatal aneuploidy screening since this syndrome is the most common autosomal trisomy among live births. Trisomies 21, 18, and 13 have first-trimester prevalences of approximately 1 in 340, 1 in 1100, and 1 in 3500, respectively A diagnosis of Down syndrome after birth is often based initially on physical signs of the syndrome. But because individuals with Down syndrome may not have these symptoms, and because many of these symptoms are common in the general population, the health care provider will take a sample of the baby's blood to confirm the diagnosis It can detect the risk of Down syndrome and is recommended in 11 to 14 weeks of pregnancy. A blood test named cell-free nucleic fetal acid [cfDNA] testing can also be opted to determine the risk of down syndrome and other chromosomal abnormalities in pregnant ladies who have a high risk of having a baby with a chromosomal abnormality A qualitative study involving 10 mothers who received a prenatal diagnosis of Down syndrome and chose to continue their pregnancy was presented. The time frame considered was diagnosis to delivery. We looked at how the diagnosis was presented, the decision to continue the pregnancy, and the mothers'

PRENATAL DIAGONOSIS OF GENETIC DISORDERSPrenatal diagnosis, gene manipulation and their ethical issuesBirth defects and prenatal diagnosis

The aims of this systematic literature review are to estimate termination rates after prenatal diagnosis of one of five conditions: Down syndrome, spina bifida, anencephaly, and Turner and. Down syndrome is primarily detected in prenatal tests, including ultrasound measurement of nuchal translucency and maternal blood tests for certain hormones (e.g., increased inhibin A and β-hCG; decreased estriol, alpha-fetoprotein, and pregnancy-associated protein A) Background: Amniotic fluid (AF) supernatant contains cell-free fetal DNA (cffDNA) fragments. This study attempted to take advantage of cffDNA as a new material for prenatal diagnosis, which could be combined with simple quantitative fluorescent polymerase chain reaction (QF-PCR) to provide an ancillary method for the prenatal diagnosis of trisomy 21 syndrome Down syndrome is the most commonly occurring chromosomal abnormality during pregnancy. It occurs when there is an extra copy of chromosome 21. This can cause mental impairment and physical abnormalities. Although there is no way of preventing Down syndrome, there are signs in pregnancy that can determine if a baby has it

screening for down syndrome - slideshare

Downs syndrome - SlideShar

Prenatal Diagnosis Support Group. DSAW has a new support group for women who have received a prenatal Down syndrome diagnosis, and due to the pandemic, this group will be held virtually using Zoom technology! The group is for women in various stages of their pregnancy and decision-making journey The objective of this study was to review the published literature on pregnancy termination following a prenatal diagnosis of Down syndrome in the United States. Method. A systematic search of US English-language articles (1995-2011) was conducted to identify primary research studies that reported data for pregnancies with definitive prenatal. Posts about Prenatal Diagnosis written by dovep7. In my research on Down syndrome, I have come across some very interesting people and I have arranged interviews with all of them and am very excited to share with you who they are and what I am hoping to learn from each of them

NIPT Market & Tech Analysis Report 2015 - Li MAEarlier, accurate & non invasive the new trigene test in

June 29, 2017 by Guest Post 5 Comments. Stephanie is an amazing mama who, while processing her daughter's Down Syndrome diagnosis and subsequent heart surgery, also managed to finish her graduate degree. Isabella has made her mama an even stronger woman, here's her story, Isabella's story that is, of a prenatal down syndrome diagnosis This allows fetal sex or rhesus D blood group to be determined without recourse to invasive prenatal diagnosis. 2,3 A highly sensitive and specific screening test for Down syndrome, called non-invasive prenatal testing, has been developed. 4-14 The test is likely to improve prenatal care Down syndrome alone is not a predictor for a child's health or quality of life. Down syndrome is a genetic condition, not a medical one, and I hope we don't continue to get this wrong. 2. Down syndrome is outside of God's design, and therefore, we should pray for a cure or negative diagnosis

A prenatal diagnosis of Down Syndrome for a Labor & Delivery nurse. April 24, 2018 by Guest Post Leave a Comment. Melody is on the medical team. Melody knows an awful lot about labor and delivery as that is what she does for a living, however, it is a whole new ballgame when the medical professional is a patient and the diagnosis is unexpected We sought to provide evidence-based recommendations to physicians on how to best deliver a prenatal diagnosis of DS to expectant parents. Our study design consisted of searching Medline and PsychInfo from 1960 to 2008, as well as Web sites from academic organizations and other nonprofit or private organizations, using the terms Down syndrome, Trisomy 21, mongolism, prenatal diagnosis. 1. Introduction. Down syndrome (trisomy 21), which has an incidence of 1 in 800 live births, is considered to be the most frequent etiology of mental retardation and it is the predominant reason for women seeking prenatal diagnosis [Driscoll & Gross, 2009].Trisomy 21 is used as a benchmark because it is the most common aneuploidy compatible with life and is associated with mental retardation. In this presentation, Dr. Brian Skotko reviews the latest advances in prenatal testing for Down syndrome. He further reviews the evidence-based research on h.. Prospective parents, if properly counselled, may want to pay for full fetal karyotyping T he portfolio of serum tests used to screen for Down's syndrome in the United Kingdom includes human chorionic gonadotrophin (hCG), unconjugated oestriol (uE3), plasma protein A (PAPP-A), and dimeric inhibin A. ADAM12, a novel serum marker with biological properties similar to PAPP-A, shows promise.1.

Nine days after the procedure, we got the call that our little girl did, indeed, have Down syndrome. Our prenatal diagnosis is somehow unusual, as we were never given the option to terminate and. The DSNetwork is here to assist you and your family members, whether you are having a baby or just had a baby with Down syndrome, as you welcome the birth of your new little one. We have a New Parent Mentoring Program that provides guidance for you and your family, connect you with another parent who received a diagnosis, either prenatal or at. The aims of this systematic literature review are to estimate termination rates after prenatal diagnosis of one of five conditions: Down syndrome, spina bifida, anencephaly, and Turner and. Introduction: Prenatal screening for Down syndrome (DS) is a routine part of prenatal care in many countries, and there is growing interest in the choices women make following a prenatal diagnosis of DS. This review describes what is known about actual and hypothetical decision making following a prenatal diagnosis of DS and adds understanding about the factors that influence women's decision.

Down syndrome - SlideShar

  1. Prenatal Diagnosis and Screening for Down Syndrome. Edited by: Subrata Dey. ISBN 978-953-307-355-2, PDF ISBN 978-953-51-6446-3, Published 2011-08-1
  2. ation rates after prenatal diagnosis of one of five conditions: Down syndrome, spina bifida, anencephaly, and Turner and Klinefelter syndromes, and to deter
  3. e whether the relatively high incidence of Down syndrome at.
  4. ation rates (1995-2011), Prenatal Diagnosis 32, 142, 2012. de Graaf G et al. Estimates of the live births, natural losses, and elective ter

Down syndrome is a genetic disorder caused when abnormal cell division results in an extra full or partial copy of chromosome 21. This extra genetic material causes the developmental changes and physical features of Down syndrome. Down syndrome varies in severity among individuals, causing lifelong intellectual disability and developmental delays This Clinical Focus provides information relating to prenatal screening and diagnosis of neural tube defects, Down syndrome, trisomy 18, and trisomy 13. It includes information about individuals suitable for testing, available tests, and test selection and interpretation for screening and diagnostic tests The case of Down syndrome: Prenatal Disadvantage. Down syndrome is the most common known cause of ID. In 1959, Lejeune identified an extra chromosome as the genetic abnormality (Lejune, Gautier, & Turpin, 1959).Until that time, amniocentesis was primarily used to treat Rh incompatibility and later to identify male fetuses at risk for hemophilia and Duchenne Muscular Dystrophy, both X-linked.

Non-Invasive Prenatal Testing

Prenatal diagnosis - SlideShar

  1. Related reading: 5 weird pregnancy symptoms you might not know about. Diagnosing carpal tunnel in pregnancy. We often can diagnose CTS by talking with you about your symptoms and medical history. If your symptoms are severe, we may recommend an electrodiagnostic study (EMG) to confirm the diagnosis and measure nerve function in the arm, wrist.
  2. A federal appeals court ruled in November that Tennessee could begin outlawing abortions because of a prenatal diagnosis of Down syndrome.The House vote came the same day that Senate Republicans.
  3. Down syndrome was first described by an English physician John Langdon Down in 1866, but its association with chromosome 21 was established almost 100 years later by Dr. Jerome Lejeune in Paris. It is the presence of all or part of the third copy of chromosome 21 which causes Down syndrome, the most common chromosomal abnormality occurring in humans.[1
  4. ation rates are high (>95%). 1-3 To explore this trend towards ter
  5. g abortions if a woman is seeking it because of race, sex or a prenatal diagnosis of Down syndrome

Prenatal diagnosis of Down syndrome: a systematic review

  1. To analyze trends in cytogenetic prenatal diagnosis in Cuba and to analyze possible causes leading to a low Down syndrome prevalence in a country where the triple test is not available. Methods. An analysis of the Cuban program in prenatal cytogenetic diagnosis from 1984 to 2012 was conducted
  2. Raleigh, N.C. — Legislation that would prevent a woman from getting an abortion in North Carolina simply because of a prenatal diagnosis of Down syndrome was on its way to Gov. Roy Cooper on.
  3. Results: If noninvasive prenatal diagnosis for Down syndrome had replaced Down syndrome screening tests in 2006 and 2007, in Victoria, there would have been 25 (7%) additional Down syndrome.
  4. Supine hypotension syndrome is more than a natural drop in blood pressure from pregnancy hormones or rest. It is a decrease of the systolic pressure (the top number) of at least 15 mm Hg to 30 mm Hg when lying on your back. 5 

Prenatal diagnosis of Down syndrome: A 13-year

  1. Prenatal diagnosis and Rett syndrome Rett syndrome is a rare neurodevelopmental disorder that is, in most cases, linked to mutations in the MECP2 gene in the X-chromosome. This gene encodes for a protein called methyl cytosine binding protein 2 (MeCP2) which is needed for brain development
  2. e the information about Down syndrome (DS) provided to pregnant women in Canada through a content analysis of prenatal screening information pamphlets. Methods: Prenatal screening information pamphlets were requested from Canadian prenatal testing centres. In total, 17 pamphlets were received (response rate = 65
  3. e the health and condition of an unborn fetus
  4. In Down syndrome, the MoM of maternal serum PAPP-A is 0.38, decreasing by 60%, and that of free β-hCG is 1.83, increasing by around two times. 21 Accordingly, both of the two markers are used in first trimester screening, and with this test, the Down syndrome detection rate is 60-74% and the false positive rate is 5%. 19 , 20 The detection.

PRENATAL DIAGNOSIS OF DOWN'S SYNDROME. Carlo Valenti. Carlo Valenti. Affiliations. Department of Obstetrics and Gynecology, State University of New York, Downstate Medical Center, Brooklyn, New York, United States. Search for articles by this author. EdwardJ • Participate in national studies such as the Duke Down Syndrome Prenatal Diagnosis study. • Support more than 65 local Down syndrome organizations in 36 states. • Manage targeted distributions to medical professionals. More than 35,000 copies of the Kennedy Foundation's Understanding a Down Syndrome Diagnosis distributed in 5 years.

We sought to provide evidence‐based recommendations to physicians on how to best deliver a prenatal diagnosis of DS to expectant parents. Our study design consisted of searching Medline and PsychInfo from 1960 to 2008, as well as Web sites from academic organizations and other nonprofit or private organizations, using the terms Down syndrome, Trisomy 21, mongolism. Every parent's heart is full of hope, love and aspirations. An unexpected diagnosis throws parents into a whirlwind of uncertainty. It's difficult to tell which direction to go, or if there even is a direction. At first, adding Down syndrome to the picture seems to crush all of the beautiful dreams Receiving a Prenatal Diagnosis of Down Syndrome for a Second Time. I'll never forget that phone call. It changed my life forever. I honestly don't remember her exact words, because all I heard was, Down syndrome.. I had been waiting for a phone call from our geneticist to confirm our 10 week, unborn baby was a girl who had Turner's. NEWBERGER D. Down Syndrome: Prenatal Risk Assessment and Diagnosis. Am Fam Physician. 2000 Aug 15;62(4):825-832. In 2007, the medical guidelines changed from only offering women 35 years old and older prenatal testing for Down syndrome to offering it to all expectant mothers Study inclusion criteria were women who received a prenatal diagnosis of Down syndrome by CVS or amniocentesis, who elected to continue the pregnancy, and whose affected child was born between 01/01/2007 and 12/31/2010. We received a total of 56 surveys completed by mothers of children with Down syndrome. There were no surveys excluded from.

Down Syndrome: Prenatal Risk Assessment and Diagnosis

Prenatal diagnosis of Down syndrom

The diagnostic procedures available for prenatal diagnosis of Down syndrome are chorionic villus sampling (CVS) and amniocentesis. These procedures, which carry up to a 1% risk of causing a spontaneous termination (miscarriage), are nearly 100% accurate in diagnosing Down syndrome. Amniocentesis is usually performed in the second trimester. Beginning in 2011, a new generation of prenatal genetic tests became available. These tests are highly accurate in determining whether a fetus has Down syndrome or a few other genetic conditions. Often referred to as non-invasive prenatal testing (NIPT), these tests require only an analysis of a maternal blood sample

Noninvasive prenatal diagnosis of Down syndrome: current

Pre-natal testing can produce a false positive but even if it doesn't somethings in life you can't get from books. Just sharing my Upside of Down syndrome Tests To Check For Down Syndrome During Pregnancy. When expecting, the best things you can do for you and your unborn baby's health is by starting prenatal care. One of the steps involved in the process of prenatal care is a test for Down syndrome. You can get two types of tests done to check to Down syndrome during pregnancy

Practice Guidelines for Communicating a Prenatal or

Massachusetts General Hospital, Down syndrome Clinic Director When expectant parents across the country receive a prenatal diagnosis, they consistently deserve to receive accurate and up-to-date information about the condition. Finally, we have that information through the booklets created by Lettercase Possible Down Syndrome - is there some form of humane abortion available? Definition and efficacy of Cardiac markers calcium deposit on babies heart in ultrasound possible down syndrome pregnancy for my daughter. Down Syndrome Now Detectable In 1st Trimester My daughter is 22 weeks pregnant and the ultrasound showed a white spot on baby's hear Down syndrome can also be diagnosed, or at least suspected, based on any of several prenatal tests including a nuchal translucency screening, sonogram, quadruple screen, or other blood tests. Here is how Down syndrome is diagnosed in both scenarios. Illustration by Verywell

Down syndrome - Diagnosis and treatment - Mayo Clini

Jia Yan, Turgay Ayer, Pinar Keskinocak and Aaron Caughey, Age‐based differences in the predictive accuracy of a one‐size‐fits‐all risk‐cutoff value in prenatal integrated screening for Down syndrome, Prenatal Diagnosis, 37, 9, (894-898), (2017) The Down Syndrome Diagnosis Network is a wonderful support to families who have just received a prenatal diagnosis. The Global Down Syndrome Foundation offers a booklet on Prenatal Testing & Information, in both English and Spanish, at no charge. Lettercase offers accurate, balanced, and up-to-date information on receiving a prenatal diagnosis And looked down one as far as I could - Robert Frost. We found out about my baby's Down syndrome diagnosis early on at 12 weeks. Early enough for no one else to know about the pregnancy. Early.

Prenatal Screening and Diagnosis of Down's Syndrome Patien

Since the early 1970s, prenatal diagnosis of Down's syndrome by karyotyping has been possible, generally by use of cultured amniotic-fluid cells obtained by amniocentesis at around 16 weeks of gestation. Each year in the UK, for example, nearly 40 000 women undergo amniocentesis, the majority because of an increased risk of having a child with. Prenatal diagnosis of Down syndrome Drew Cratsenberg, MS, LCGC Licensed and Certified Genetic Counselor Munroe-Meyer Institute for Genetics and Rehabilitation Methodist Perinatal Center. Conflicts of Interest • I have no conflicts of interest nor any financia In the case of Down Syndrome, the child receives an extra of Chromosome 21, for a total of three. In the case of Trisomy 18, there are three sets of Chromosome 18. Mutations in the number of chromosomes (either more or less) will affect the way the baby grows and learns. People who share the same variance in chromosomes will display similar traits Screening for Down Syndrome in Pregnancy. All pregnant women have to undergo a screening diagnosis for Down syndrome. The screening tests generally include an ultrasound and some blood tests. It is usually done in the first trimester of pregnancy. If a mother misses to have this test, she can take the test in the second trimester

Prenatal Diagnosis - PubMed Central (PMC

Pregnancy & Baby. Welcome to our information for pregnant women, expectant couples, maternity healthcare professionals and new parents. If you have any questions about Down's syndrome during or after pregnancy please call our Helpline.We are trained to listen to you, answer questions about Down's syndrome and to provide information and support 1 INTRODUCTION. Down syndrome (DS), often caused by trisomy 21, is the most common aneuploidy in humans. Because average maternal age has increased in Europe 1-3 and livebirth (LB) prevalence of DS increases with maternal age, 4 an increase in DS LB prevalence over time may be expected. However, prenatal screening and termination of pregnancy (TOP) for DS counterbalance this expected increase. Flinter F. The future of prenatal diagnosis: rapid testing or full karyotype? An audit of chromosome abnormalities and pregnancy outcomes for women referred for Down's Syndrome testing. BJOG: An International Journal of Obstetrics & Gynaecology (2005) 112: 1369-1375. 3. Neilson JP, Alfirevic Z. Optimising prenatal diagnosis of Down's syndrome

Prenatal Diagnosis Down syndrome diagnosis RMDSA

OBJECTIVE: To compare the cost and benefits of prenatal diagnosis for Down syndrome using the British and American approaches. METHODS: This cost-benefit analysis was based on a decision-analytic approach. The British strategy included screening by a first-trimester ultrasound at 10-14 weeks for nuchal translucency thickness, and the American. Down syndrome occurs in around 1 in every 700 pregnancies. It is determined by many factors, but research suggests that there is a higher chance if the mother is older than 35 years of age The first prenatal diagnosis of Down syndrome was made in 1968, and screening women with amniocentesis on the basis of advanced maternal age was gradually introduced into medical practice Despite these underlying changes, it is striking that for women older than 36 years with a Down's syndrome pregnancy, the proportion who have had an antenatal diagnosis has remained constant at 70%, and for all women with an antenatal diagnosis of Down's syndrome the proportion who decide to terminate the pregnancy has remained constant at 92% Recently, the National Down Syndrome Society and the National Down Syndrome Congress announced the selection of a booklet (Understanding a Prenatal Down Syndrome Diagnosis) as a gold standard.

Abortion and Down Syndrome - Healthlin

Down Syndrome (DS) is a genetic disorder originated during the meiotic process, produced by the copy of chromosome 21, causing a trisomy that affects the way in which the physical and cognitive. This course employs Brighter Tomorrows, an interactive resource to educate clinicians on how to give a prenatal diagnosis of Down syndrome, using two simulated sessions with a high-risk patient and her husband. Add to Cart. Categories: Prenatal Testing, Preservice Health Training The experimental Down syndrome test screens for genetic markers of the developmental disorder in blood samples taken from the mother between the 11th and 14th weeks of pregnancy. Early testing of. Roughly 67 to 85% of pregnancies with a prenatal diagnosis of Down syndrome were aborted from 1995 to 2011, according to a 2012 review published in the medical journal Prenatal Diagnosis. As a.


House advances ban on abortions over Down syndrome diagnoses. HARRISBURG, Pa. (AP) — Republicans in the Pennsylvania House pushed through a bill Tuesday that would ban abortions that are prompted by a prenatal Down syndrome diagnosis, although the Democratic governor has vowed to veto it. State representatives voted 120-83 for legislation. 1. Am J Med Genet. 2000 Aug 28;93(5):410-6. Determinants of parental decisions after the prenatal diagnosis of down syndrome: bringing in context Prenatal testing consists of prenatal screening and prenatal diagnosis, which are aspects of prenatal care that focus on detecting problems with the pregnancy as early as possible. These may be anatomic and physiologic problems with the health of the zygote, embryo, or fetus, either before gestation even starts (as in preimplantation genetic diagnosis) or as early in gestation as practicable FILE - In this Nov. 10, 2020, file photo, Tennessee Gov. Bill Lee speaks with reporters in Nashville, Tenn. A federal appeals court ruled Friday, Nov. 20, 2020, that Tennessee can begin outlawing abortions because of a prenatal diagnosis of Down syndrome, as well prohibit the procedure if it is based on the race or gender of the fetus