Common indications for referral () 1. Previous child with multiple congenital anomalies. mental retardation or an isolated birth defect. such as neural tube defect, cleft lip and palate. 2. Family history of a hereditary condition such as cystic fibrosis, fragile x syndrome, or diabetes 3. Prenatal diagnosis for advanced maternal age or other indicationCommon indications for referral (I) 1. Previous child with multiple congenital anomalies, mental retardation or an isolated birth defect, such as neural tube defect, cleft lip and palate. 2. Family history of a hereditary condition, such as cystic fibrosis, fragile X syndrome, or diabetes. 3. Prenatal diagnosis for advanced maternal age or other indication