The Center for Fetal Medicine and Prenatal Genetics includes high-risk obstetricians, geneticists, radiologists, genetic counselors and nurses who provide assessment and counseling services before, during, and after pregnancy. Consultations are available at Brigham and Women’s Hospital and locations throughout the community.
Our genetic counselors help patients:
Before a genetic counseling appointment, patients are encouraged to speak with their family members and their partner’s family members about the following:
If there is a specific genetic condition in the family, it is important to obtain copies of evaluations and genetic testing results.
Our team offers comprehensive diagnostic testing for patients during their pregnancy when an increased risk for a genetic condition is identified, including:
Tests such as maternal serum screening or cell-free DNA may be performed to identify an increased risk for a chromosome condition such as Down syndrome.
Genetic Carrier Testing
Genetic carrier testing can identify whether a couple is at risk for have a children with an inherited genetic condition.
Ultrasound may be performed during pregnancy to identify a birth defect.
In situations like these, our team provides education and support to patients to determine further testing and management options. In some cases, patients may choose to have additional diagnostic testing, such as:
During amniocentesis a small sample of the fluid that is around the baby (amniotic fluid) is removed from the uterus for testing.
Chorionic Villus Sampling
During chorionic villus sampling (CVS) a small piece of the placenta (chorionic villi) is removed from the placenta for testing.
Percutaneous Umbilical Blood Sampling (PUBS)
Percutaneous umbilical blood sampling is performed under ultrasound guidance to remove a sample of fetal blood.
If an amniocentesis, chorionic villus sampling or PUBS is planned:
Typically, diagnostic testing is performed to obtain fetal cells for genetic testing of the chromosomes or DNA. Chromosomes are made up of DNA and groups of DNA in specific patterns are called genes. Diagnostic testing may include:
A picture of the chromosomes that detects whole extra or missing chromosomes or large chromosome variations.
DNA testing of the chromosomes that detects extra or missing chromosomal material in greater detail than a karyotype. Chromosome microarray does not test for single-gene conditions or provide information about how genes work.
Single Gene Conditions
Targeted DNA testing may be performed to look at a specific gene associated with a constellation of birth defects. Decisions about single gene testing are made based on the clinical information and known genetic causes. In some cases, further genetic testing can involve examination of specific panels of genes or the exome.
For families expecting the birth of a child with a birth defect or genetic condition, coordinated care including high risk obstetric care, neonatology and pediatric subspecialty care are arranged.
After a pregnancy loss or delivery of a child with birth defects, families have questions about why such an event happened and the impact for future pregnancies. While there are many causes for birth defects and pregnancy loss, genetic testing may detect a specific genetic cause. Additional genetic testing may be suggested to understand recurrence risks in future pregnancies.
Chromosome testing through chromosome microarray is recommended. Even if this testing is normal, it does not rule out an underlying genetic cause. Innovative genetic testing including single-gene testing, directed gene panels and exome sequencing may provide additional information.
Based on clinical information and genetic testing, our team can review testing options for a future pregnancy. If a known genetic cause is identified, diagnostic testing such as CVS or amniocentesis can be offered in a future pregnancy. There may also be an option for pre-implantation genetic diagnosis (PGD), detailed below. Even if there is no known genetic cause, screening by ultrasound or other imaging, such as an MRI or echocardiogram, may also be beneficial.
Pre-implantation genetic diagnosis (PGD) allows for genetic testing of embryos following in-vitro fertilization. PGD increases the probability that the embryos transferred will be unaffected for the disease tested. PGD is only possible for conditions where there is a known genetic cause. Genetic counselors work in conjunction with the fertility specialists in the BWH Center for Infertility and Reproductive Surgery to coordinate this testing.
Our genetic counselors provide educational programs and support to physicians and their office staff. Advances in the decoding of the human genome often places genetic testing, as well as the interpretation and application of these tests, in the physician’s office. Programs taught by genetic counselors can support implementation of prenatal genetic services to the obstetric community.
To schedule an appointment or to learn more about our services, please contact us at (617) 732-4840.
Brigham and Women’s Hospital
75 Francis Street
Boston, MA 02115
Louise E. Wilkins Haug, MD, PhD
Division of Maternal-Fetal Medicine
Rosemary E. Reiss, MD
Division of Maternal-Fetal Medicine
The genetic counselors in the Center for Fetal Medicine and Reproductive Genetics have completed a master’s in genetic counseling and are licensed and board certified (CGC). The genetic counselors have expertise in reproductive genetics including counseling families prior to and during pregnancies, reviewing genetic testing options surrounding pregnancy, preimplantation genetic testing (PGT), and prenatal diagnosis of birth defects and genetic conditions.
Lori Dobson, MS, CGC
Genetic Counseling Director, Genetic Counselor
Lori Dobson, CGC (she/her) graduated from California State University Northridge. She loves helping to support families and approaches complex genetic cases with compassion and ingenuity. In addition to clinic, she manages the genetic counseling team, leads the reproductive genetics program, and directs genetic counseling services throughout the OB/GYN department. She also participates on MGB Genetic Counseling Committees and Task Forces to improve integration of genetic services throughout the enterprise.
Sophie Adams, MSc, MS, CGC
Maternal Fetal Care Genetics Program Manager (BWH), Genetic Counselor
Sophie Adams, CGC (she/her) graduated from Stanford University and also has a MSc in Physiology, Anatomy, and Genetics from the University of Oxford. She manages the Maternal Fetal Care Genetics program affiliated with Boston Children’s Hospital and oversees genetic testing for patients delivering at the Brigham. Sophie specializes in genetic counseling and supporting patients with complex fetal anomalies. She strives to evaluate and bring cutting edge technology into clinic to maximize prenatal and neonatal diagnoses.
Meghan Dean, MS, CGC
Operations Manager, Genetic Counselor
Meghan Dean, CGC (she/her) graduated from Boston University’s genetic counseling training program and joined the team in 2019. As the clinical lead in our Donor Gamete Program, she has a particular interest in supporting individuals and families as they navigate the many avenues to parenthood and family building. Meghan takes an empathetic and patient-first approach to supporting patients as they navigate the technical, emotional, and ethical complexities of prenatal and reproductive care.
Courtney Studwell, MS, CGC, MB(ASCP)CM
Molecular Genetics Program Manager, Genetic Counselor
Courtney Studwell, CGC (she/her) graduated from Boston University and holds a laboratory certification in molecular biology. In addition to seeing patients, she works in the BWH genetics laboratory and is passionate about bringing new genetic technology into the clinic. Courtney is an Adjunct Assistant Professor at the MGH IHP Genetic Counseling Program.
Olivia Maher, MS, CGC
Olivia Maher, MS, CGC (she/her) graduated from Long Island University - Post. Olivia is passionate about counseling families with complex fetal anomalies by connecting them to resources and guiding them through how genetic information may be helpful. She strives to create an environment where patients feel informed and empowered to make difficult decisions about their care.
Sofia Horan, MS, CGC
Sofia Horan, MS, CGC (she/her) graduated from Sarah Lawrence College. Sofia strives to be a valuable resource to her patients throughout the reproductive process. Her professional interests include advocating for policies that increase access to genetic services in order to provide exceptional patient care.
Christina Miller, MS, CGC
Christina Miller, MS, CGC (she/her) graduated from the University of Colorado-Anschutz Medical Campus. Christina is dedicated to supporting individuals and families throughout their reproductive journey. By fostering a compassionate and informed environment, she strives to help families navigate the complexities of genetic information and help them make decisions with confidence.
Amy Ren, MS
Amy Ren, MS (she/her) graduated from the University of Pennsylvania’s Program in Genetic Counseling. Amy is committed to delivering compassionate care by acknowledging and meeting the unique needs of individuals and families throughout the reproductive journey. Her professional interests include advancing access and equity in reproductive services through educational efforts, community engagement, and coordinated care.
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