Meeting patients' education and decision-making needs for first trimester prenatal aneuploidy screening

• Published in: Prenatal diagnosis 2011-12, Vol.31 (13), p.1222-1228
• Main Authors: Farrell, Ruth M., Nutter, Benjamin, Agatisa, Patricia K.
• Format: Article
• Language: English
• Subjects: Abortion, Legal; Adult; Aneuploidy; Biological and medical sciences; Cross-Sectional Studies; Decision Making; Delivery. Postpartum. Lactation; Down Syndrome - diagnosis; Female; first trimester aneuploidy screening; Fundamental and applied biological sciences. Psychology; Genetic Testing; Genetics of eukaryotes. Biological and molecular evolution; Gynecology. Andrology. Obstetrics; Health Knowledge, Attitudes, Practice; Humans; informed consent; Medical sciences; Middle Aged; Molecular and cellular biology; Patient Education as Topic; Pregnancy; Pregnancy Trimester, First; Prenatal Diagnosis - adverse effects; Risk; Surveys and Questionnaires
• ISSN: 0197-3851; 1097-0223
• DOI: 10.1002/pd.2867

Objective First trimester aneuploidy screening introduces unique challenges to patient education and informed decision‐making. Our study assessed the decision‐making process among those pregnant patients presenting for this new form of aneuploidy screening. Method A survey instrument was used to assess components of decision‐making among women who presented for first trimester aneuploidy screening. Knowledge and leading factors in the decision‐making process were measured. Results Participants (n = 139) demonstrated understanding of the etiology of Down syndrome, but less understanding of its cognitive (65.2%) and physical manifestations (58.7%). Few were able to determine risk from first trimester screen results (36.7%). Participants were more familiar with amniocentesis (84.2%) than chorionic villus sampling (73.4%), though less familiar with procedural risks (29.5% and 28.1%, respectively). The majority of participants ranked the following as key information in their decision: knowledge of their intentions about the outcome of the pregnancy based on the test results (92.4%), knowledge of chorionic villus sampling to evaluate an abnormal result (92.0%), and values and beliefs about termination (89.1%). Conclusion First trimester aneuploidy screening generates education and decision‐making benchmarks for patients and providers. It is important to address these barriers as this new screen becomes a growing part of current prenatal genetic testing offerings. Copyright © 2011 John Wiley & Sons, Ltd.