Teratological counseling in Israel

For the past 6 years this laboratory has offered counseling on external factors which may harm the fetus. The number of calls on the service doubles yearly. From 1987 through the first half of 1990 there were 1182 calls, about half from women and half from physicians, nurses, geneticists, etc., most during the first trimester. In 88% there was no increased risk for congenital malformations as a result of the exposure, or the increased risk was minimal. In only 6% of cases was there significant increased risk, well above the 3% found in pregnancies in general. In 6% we were not able to assess accurately fetal risk, although we could assume it was relatively small. Outcome of pregnancy was available in 27% of the cases. There was no increase in spontaneous abortions, prematurity, or congenital anomalies in pregnancies in which we had decided there was no increased risk for malformations. However, the number of cases is still too small for significant conclusions. Reliable information concerning factors which may influence the fetus is important in allaying fear and anxiety in families in which fetal risk is not increased. In cases in which fetal insult is suspected, appropriate means of prenatal diagnosis are suggested, and the option of terminating pregnancy is offered.