Essential Counseling Prompts: Fetal Malformations

You are an obstetrician writing for pregnant patients. Create a ONE-PAGE patient information sheet that explains what an anatomy ultrasound (the anatomic sonogram, usually done at 18 to 22 weeks) is. Write at a 6th-grade reading level: short sentences, everyday words, and no medical jargon. If a medical word is unavoidable, define it in plain language right away. Cover these points: - What this scan is and why it is done - When in pregnancy it happens (around 18 to 22 weeks) - What the person doing the scan looks at (brain, face, heart, spine, stomach, kidneys, bladder, arms, legs, the placenta, and the fluid around the baby) - What the scan can find and what it cannot find - That a normal scan lowers the chance of a problem but cannot rule everything out - That sometimes a finding means a repeat scan or extra tests are needed - That the scan does not hurt the baby or the mother Use a short, friendly title and clear simple headings. Keep a calm, honest, reassuring tone. Keep it to one page. Do not invent statistics. If you include any number, keep it accurate and general, and list at the end which statements I should verify before giving this sheet to a patient.

You are a maternal-fetal medicine specialist writing for a pregnant patient and her family. I will give you one fetal diagnosis: [ENTER THE FETAL MALFORMATION HERE] Before writing, do deep, careful research and base everything on current, authoritative sources (peer-reviewed literature; ACOG, SMFM, FIGO, and ISUOG guidance; major fetal-medicine references). Then write a CONCISE PATIENT information sheet at a 6th-grade reading level. Use plain, everyday language and short sentences. If a medical word is unavoidable, define it right away. Cover the essentials clearly without overwhelming her. Cover: - What this condition is, in plain words - How the affected body part normally works and what is different here - How common it is - What was seen on the ultrasound and what each finding means - What other tests may be offered, and why each one is done - What it may mean for the baby during pregnancy, at the time of birth, and after birth — the full range of outcomes, from the most hopeful to the most serious, told honestly - What treatments, surgery, or special care the baby might need, and roughly when - The options and choices: more testing, monitoring, specialist and delivery planning, and the full range of choices — presented with NO pressure - Questions she may want to ask her care team - Where to find trustworthy support and information Tone: calm, compassionate, honest, and non-directive. LENGTH: Keep it to no more than 2–3 pages (roughly 800–1,200 words). This is a take-home sheet for a worried family, not a booklet — be brief and clear, use short sections with simple headings, and leave out anything that is not essential. Do not exceed this length. STRICT RULES — NO HALLUCINATIONS: - Do NOT invent or guess anything. Every fact, number, incidence, survival rate, or outcome must be confirmed against authoritative sources. - If you are not certain about something, say so plainly instead of guessing. - Mark clearly any statement that is uncertain or where the evidence is limited. - At the very end, list every statistic and claim I should personally verify before giving this sheet to a patient. This is a draft for me to review, verify, and edit — not a final handout.

You are a maternal-fetal medicine specialist preparing a detailed clinical reference for a colleague. I will give you one fetal diagnosis: [ENTER THE FETAL MALFORMATION HERE] Do deep, careful research grounded in current peer-reviewed literature and major guidelines (ACOG, SMFM, FIGO, ISUOG, and the relevant subspecialty societies). Then produce a CONCISE clinician reference — a working summary for a busy colleague, NOT a textbook chapter. Cover, in tight clinical prose with short bullets and no padding: - Definition, embryology / pathophysiology, and classification or subtypes - Incidence, epidemiology, and risk factors - Sonographic and other imaging findings, diagnostic criteria, and differential diagnosis - Associated structural anomalies, genetic syndromes, and chromosomal associations - Recommended workup: detailed anatomy survey, fetal echocardiography, fetal MRI where indicated, genetic counseling and testing (karyotype, microarray, and gene panel / exome where appropriate) - Antenatal surveillance and management; any fetal therapy options and the evidence behind them - Prognosis: survival, morbidity, and long-term neurodevelopmental / functional outcomes, with the strength of evidence noted - Delivery planning: timing, mode, and location of delivery - Neonatal and postnatal management, including which specialists to involve - Recurrence risk and preconception / future-pregnancy counseling - Key counseling points and shared-decision-making considerations LENGTH: Keep the whole document to no more than about 4 pages (roughly 1,500–1,800 words). Be selective — one or two crisp lines per section, the highest-yield facts only. If a section has nothing essential to add, say so in a line rather than padding it. Do not exceed this length even if it means leaving out lower-yield detail. STRICT RULES — NO HALLUCINATIONS: - Use ACOG gestational-age terminology precisely (early term 37 0/7–38 6/7; full term 39 0/7–40 6/7; late term 41 0/7–41 6/7; post-term 42 0/7 and beyond). - Do NOT fabricate or extrapolate. Every incidence figure, survival / morbidity rate, recurrence risk, and recommendation must be confirmed against authoritative sources. - When you cite, give a real, checkable reference in Vancouver format; never invent a citation, DOI, or PMID. - If you are not certain about any value, state that clearly instead of guessing. - Distinguish established evidence from emerging data and from expert opinion, and note where evidence is limited. - Flag every claim I should verify against a primary source before clinical use. This is a draft for my review and verification.

You are a maternal-fetal medicine specialist and clinical geneticist helping me build a differential diagnosis from prenatal ultrasound findings. It is hard to remember which syndromes carry which findings, so work carefully and completely. STEP 1 — COLLECT ALL FINDINGS FIRST. Do NOT generate a differential yet. I will enter every sonographic finding below. Once I do: - Restate the findings back to me, organized by system. - Tell me which major systems or structures I have NOT mentioned (CNS, face / profile, heart, chest, abdomen and abdominal wall, kidneys / urinary tract, skeleton and limbs, placenta, amniotic fluid, growth / biometry, fetal sex). - Ask me to confirm the list is complete or to add anything missing — including structures that were checked and looked NORMAL, and the gestational age. Only after I confirm the list is complete do you move to Step 2. FINDINGS (enter everything here, then send): [LIST ALL ULTRASOUND FINDINGS + GESTATIONAL AGE] STEP 2 — DIFFERENTIAL. After I confirm the list, produce a RANKED list of syndromes and conditions whose recognized features best fit this constellation. For EACH candidate give: - The name (and OMIM number if you are sure of it) - Which of my findings support it, and which expected features are absent or were not reported - The single most discriminating or pathognomonic feature that would confirm or exclude it - The usual genetic basis and the confirmatory test (karyotype, microarray, or targeted gene / panel / exome) that would establish or rule it out - A rough relative likelihood for this constellation (high / moderate / low), with your reasoning Then close with: the one most useful next test to narrow the differential, and any red-flag finding I should not miss. STRICT RULES — NO HALLUCINATIONS: - Base every association on established genotype–phenotype and sonographic literature. Do NOT invent syndromes, gene names, OMIM numbers, or feature associations. - If the findings are nonspecific or do not point to a recognized syndrome, say so plainly rather than forcing a diagnosis. - Separate well-established associations from weak or anecdotal ones, and state your certainty for each. - If you are unsure about any association, say so. - This is a hypothesis-generating aid for me to verify against primary sources and confirm with genetics — not a diagnosis.

Create a clinical reference table on the advantages of using generative AI for [SPECIFY DOMAIN — e.g., counseling after a prenatal diagnosis of fetal malformations]. Columns: (1) Rank, (2) Advantage, (3) What it does, (4) Application in this clinical context, (5) Caveat / required clinician oversight. Rules: - Order rows by practical importance, most impactful first; aim for 10–14 rows. - Keep each cell to one or two lines. - For any claim that is an empirical finding rather than a general capability (for example, that AI is rated as more empathic than clinicians), mark it clearly and give a real, checkable Vancouver citation. Do not invent references; if you cannot verify a claim, say so instead of asserting it. - The "Caveat / oversight" column must name the specific review step a clinician should apply, so the table never reads as uncritical promotion. Output as a clean markdown table.

Create a one-page patient information sheet, at a 6th-grade reading level, that prepares a pregnant patient for the 18–22 week anatomy ultrasound (the "anatomy scan"). Use a friendly question-and-answer format with short headings, such as: What is this scan for? · What will be checked? · What happens during it? · How long does it take? · Why does it matter? · What should I do before? · Can I bring someone? Content rules: - List the structures examined: head and brain, face, heart and its chambers, spine, stomach, kidneys, bladder, arms and legs, hands and feet, amniotic fluid, placenta, umbilical cord, and sex if the patient wants to know. - State plainly that the scan does not hurt, takes about 20–45 minutes, and that most scans are normal. - Include one honest sentence: a normal scan lowers but does not remove the chance of a problem, and some findings need a repeat scan or extra tests. - Calm, reassuring tone; short sentences; define any unavoidable medical word. - Keep it to one page (about 400–500 words). Do not invent statistics; flag any number for me to verify before use. Output as clean, printable text.

Generate a clinical reference table linking common fetal anomalies to their recognized syndrome associations and the additional features to evaluate. Columns: (1) Primary anomaly, (2) Most clinically relevant associated syndromes, (3) Additional ultrasound features to assess, (4) Single most discriminating feature that shifts the differential, (5) Confirmatory test (karyotype / microarray / targeted gene or panel / exome), (6) How often the anomaly is isolated vs syndromic. Rules: - Include 12–16 of the highest-yield anomalies. - List only well-established genotype–phenotype and sonographic associations. Do NOT invent syndromes, gene names, OMIM numbers, or feature links. - Where an association is weaker or debated, label it as such rather than listing it as definite. - Keep cells terse. - At the end, list any rows or associations you are not fully certain about, so I can verify them against primary sources before clinical use. Output as a clean markdown table.

Create a table of the ways generative AI can assist AFTER an abnormal fetal ultrasound diagnosis. Columns: (1) Function, (2) What the AI does, (3) Benefit to patient and clinician, (4) Required clinician check before it reaches the patient. Rules: - Provide 10–14 functions, ordered by impact on patient understanding and shared decision-making. - The "clinician check" column must name the specific review each output needs — for example, confirm statistics, confirm the tone is not falsely reassuring, confirm options reflect local law. - Keep every cell to one or two lines. - Do not overstate: each function supports, and never replaces, the clinician's disclosure and interpretation — reflect that in the wording. Output as a clean markdown table.

Generate a reusable library of counseling prompt templates — one per fetal anomaly — that I can copy and adapt at the bedside. Cover the highest-yield anomalies, for example: ventriculomegaly, spina bifida, congenital diaphragmatic hernia, omphalocele, gastroschisis, cystic hygroma, clubfoot, echogenic bowel, hypoplastic left heart and other major cardiac defects, agenesis of the corpus callosum, holoprosencephaly, cleft lip and palate, duodenal atresia, fetal growth restriction, renal anomalies, and absent nasal bone. Give every template the SAME skeleton with bracketed fill-ins: "Counsel a patient at [gestational age] whose fetus has [anomaly — isolated, or with these findings: ___]. Explain in [reading level, e.g., 6th-grade] language: what it is, what was seen, the prognosis with the honest range of outcomes, the likely next tests and consults, and the options without pressure. Tone: [calm / supportive / hopeful, as the prognosis warrants]. Keep to [length]. Do not invent statistics; flag every number I should verify; say plainly where evidence is limited. This is a draft for me to review before sharing." Rules: - Use ACOG gestational-age terminology where relevant. - Match tone to prognosis honestly — do not make a lethal anomaly sound hopeful, or a treatable one sound grim. - For anomalies that can be isolated or syndromic, the template must prompt for which. - Do not bake any specific statistic or outcome figure into the templates — leave those to be filled and verified per case. Output as a markdown table with columns: Anomaly · Example gestational age · Ready-to-use prompt template.