When should genetic counseling be considered in fetal CHD?

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Genetic counseling is most appropriate when a fetal CHD is identified, especially if there are multiple anomalies, dysmorphic features, or a family history of CHD or genetic syndromes. These signs raise the suspicion for an underlying genetic condition and affect recurrence risk and testing decisions for the current and future pregnancies. Through counseling, parents learn about possible genetic etiologies, the range of testing options (like chromosomal microarray or targeted/sequencing tests), what results mean for prognosis and management, and the limitations of testing. This guidance is useful even before any chromosomal abnormality is confirmed, and it should be offered prenatally when CHD is detected, rather than waiting until after birth.