Get the free Prenatal Microarray Requisition

This form is to be used for submitting prenatal microarray testing to the Genetics Laboratory. It includes sections for patient and physician information, specimen type, clinical information, and

How to fill out prenatal microarray requisition

How to fill out Prenatal Microarray Requisition

1. Obtain the Prenatal Microarray Requisition form from your healthcare provider or the genetics laboratory.
2. Fill in the patient's personal information, including name, date of birth, and contact information.
3. Provide the referring physician's details, including their name, contact information, and practice address.
4. Indicate the reason for the prenatal microarray testing by checking the appropriate box or providing a brief explanation.
5. Include relevant clinical information, such as family history, pregnancy details, and any previous genetic tests conducted.
6. Specify the sample type (e.g., amniotic fluid, chorionic villus sampling) and include any associated identifiers.
7. Sign and date the requisition to confirm the request.
8. Review the form for completeness and accuracy, then submit it according to your healthcare provider's instructions.

Who needs Prenatal Microarray Requisition?

1. Pregnant individuals who have abnormal ultrasound findings.
2. Patients with a family history of genetic disorders.
3. Those with a previous child born with a genetic condition.
4. Expecting parents with concerns about potential chromosomal abnormalities.

People Also Ask about

What sample is required for prenatal testing by microarray?

A maternal blood sample is requested when ordering this test (see PPAP / Parental Sample Prep for Prenatal Microarray Testing, Blood); the PPAP test must be ordered under a different order number than the prenatal specimen.

Can autism be detected in genetic testing?

Chromosomal microarray analysis is recommended for individuals with a diagnosis of autism spectrum disorder, intellectual developmental disorder, or global developmental delay.

Can microarray detect autism?

Copy number variants (CNVs) detected by chromosomal microarray analysis (CMA) significantly contribute to understanding the etiology of autism spectrum disorder (ASD) and other related conditions.

What is a microarray test in pregnancy?

The test is also known as chromosomal microarray, whole genome microarray, array comparative genomic hybridization (array CGH or aCGH) or SNP microarray. This test helps to find out if your child has a medical condition caused by: a small missing piece of chromosome, called a deletion.

What disorders can microarray detect?

Chromosomal microarray (CMA) is increasingly utilized for genetic testing of individuals with unexplained developmental delay/intellectual disability (DD/ID), autism spectrum disorders (ASD), or multiple congenital anomalies (MCA).

How good is microarray at detecting autism?

We found that the probability of elucidating the etiology of microarray method in autism spectrum disorder, intellectual disability, and multiple congenital anomalies is 13.6% with a percentage similar to the literature.

What disorders can microarray detect?

Chromosomal microarray (CMA) is increasingly utilized for genetic testing of individuals with unexplained developmental delay/intellectual disability (DD/ID), autism spectrum disorders (ASD), or multiple congenital anomalies (MCA).

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What is Prenatal Microarray Requisition?

The Prenatal Microarray Requisition is a document used to request genetic testing in prenatal cases. It allows healthcare providers to gather necessary information to perform microarray analysis on fetal samples.

Who is required to file Prenatal Microarray Requisition?

Healthcare providers, such as obstetricians or genetic counselors, are required to file the Prenatal Microarray Requisition when they are referring a patient for genetic testing during pregnancy.

How to fill out Prenatal Microarray Requisition?

To fill out the Prenatal Microarray Requisition, the healthcare provider must provide patient information, medical history, details about the pregnancy, and any relevant familial genetic information. The requisition should be completed thoroughly to ensure accurate testing.

What is the purpose of Prenatal Microarray Requisition?

The purpose of the Prenatal Microarray Requisition is to facilitate the genetic analysis of fetal DNA to detect potential chromosomal abnormalities and provide families with critical information regarding the health and development of the fetus.

What information must be reported on Prenatal Microarray Requisition?

The information that must be reported includes the patient's demographic information, clinical reason for testing, gestational age, prior pregnancy history, and any known family genetic conditions.