Kaiser program blazes CF screening trail.

While the American College of Obstetricians and Gynecologists is scrambling to make cystic fibrosis carrier screening a routine part of obstetric care, the physicians at Kaiser Permanente of Northern California have their program firmly in place.

In November 1999, Kaiser's program for cystic fibrosis (CF) carrier screening began to routinely present the screening option to all pregnant women and their partners among the 3 million people enrolled in the Northern California region of Kaiser Permanente, said Dr. David R. Witt, director of the group's regional CF screening program.

Since the program's inception, CF screening has been chosen by about 70% of pregnant women and has involved about 46,000 tests done by Kaiser's in-house laboratory. The screening option is presented to pregnant women and their partners at the prenatal classes that Kaiser had in place before the program began. Basic information is usually introduced in a video.

Among the women tested, about 1,500 were identified as carriers of mutations linked with severe forms of CF. The partners of these women were tested, which led to the identification of about 50 high-risk couples in which both partners carried a CF mutation. These couples were then offered more intensive genetic counseling and the option of fetal testing. This led to several terminations of fetuses that ...