ACOG and SMFM Endorse Chromosomal Microarray Analysis (CMA) for Prenatal Diagnosis

ACOG and SMFM Endorse Chromosomal Microarray Analysis (CMA) for Prenatal Diagnosis

The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) have issued an official committee opinion recommending Chromosomal Microarray Analysis (CMA) as the first-line genetic test in pregnancies where fetal abnormalities are detected on ultrasound.

This global endorsement marks a significant shift in prenatal genetic testing practices, moving beyond standard karyotyping to a more accurate, reliable, and advanced test.

Why CMA is Superior to Karyotyping

• Higher accuracy: CMA detects small chromosomal imbalances (microdeletions and duplications) that traditional karyotyping often misses.

• Computer-based analysis: Unlike manual karyotyping, CMA uses advanced bioinformatics, reducing the risk of human error.

• Better results in complex cases: Especially useful in stillbirths, intrauterine fetal demise, and pregnancies with ultrasound-detected anomalies.

At LABASSURE, we provide high-resolution chromosomal microarray testing with clinical interpretation by expert geneticists to ensure accurate, actionable results.

ACOG & SMFM Recommendations for CMA Use

According to Committee Opinion #581 – “The Use of Chromosomal Microarray Analysis in Prenatal Diagnosis”, the following guidelines are provided:

1. Pregnancies with fetal abnormalities

• If one or more major structural abnormalities are seen on ultrasound and invasive prenatal testing is being performed, CMA is recommended instead of karyotyping.

2. Structurally normal fetus

• Either fetal karyotyping or CMA may be performed if invasive prenatal diagnosis is indicated.

3. Not restricted by maternal age

• CMA detects abnormalities not linked to maternal age, so its use should not be limited to women ≥35 years.

4. Intrauterine fetal demise (IUFD) / Stillbirth

• CMA should be performed on fetal tissue (amniotic fluid, placenta, or products of conception) as it provides higher detection rates compared to karyotyping.

5. Pregnancy loss (first or second trimester)

• Limited evidence is available, so CMA is not routinely recommended for early pregnancy losses at this time.

6. Genetic counseling is essential

• Patients should receive pre-test and post-test counseling from a qualified genetic counselor or geneticist.

• Informed consent must include discussions about:

• Variants of uncertain significance (VUS)

• Possible findings of consanguinity or non-paternity

• Risk of identifying adult-onset genetic conditions

Key Takeaways

• CMA is now the recommended first-line test for pregnancies with ultrasound-detected abnormalities.

• It offers superior accuracy over karyotyping and is applicable across all maternal ages.

• CMA is also the preferred test for stillbirths and fetal demise evaluations.

• Genetic counseling is critical before and after testing to help families understand the results and implications.

LABASSURE Advantage

At LABASSURE, we follow international best practices aligned with ACOG and SMFM guidelines, offering:

• High-resolution chromosomal microarray testing

• Expert clinical genetic interpretation (not just raw bioinformatics output)

• Comprehensive pre- and post-test genetic counseling

• Support for obstetricians, gynecologists, and fetal medicine specialists in managing high-risk pregnancies

📧 For more information about Chromosomal Microarray Analysis in pregnancy or to book a test, contact us at info@labassure.com

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