Patient and provider attitudes toward screening for Down syndrome in a Latin American country where abortion is illegal |
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Authors: | Amy E. Wong Miriam Kuppermann Jennifer M. Creasman Waldo Sepulveda Juan E. Vargas |
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Affiliation: | aDepartment of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois, USA;bDepartment of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, USA;cDepartment of Epidemiology and Biostatistics, University of California, San Francisco, California, USA;dMedical Effectiveness Resource Center for Diverse Populations, University of California, San Francisco, California, USA;eFetal Medicine Center, Department of Obstetrics and Gynecology, Clinica Las Condes, Santiago, Chile |
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Abstract: | ObjectiveTo examine patient and provider attitudes toward first trimester nuchal translucency (NT) screening for Down syndrome and to assess how patients consent to screening in a country where abortion is illegal.MethodsPatients presenting for first trimester ultrasound including NT screening in two obstetric units in Chile completed a questionnaire about their attitudes toward NT screening and perspectives on the consent process. A follow-up questionnaire assessed satisfaction with the test. Prenatal care providers also completed a questionnaire ascertaining their perspectives on NT screening.ResultsA total of 107 patients completed the initial questionnaire and 78 completed the follow-up questionnaire. Although 98 (94%) patients desired NT screening only 38 (38%) indicated that they would undergo diagnostic testing if they received screen positive results. Only 3 patients screened positive; however, 15 (20%) participants experienced increased anxiety after the test. Almost all of the 36 providers surveyed indicated that they counsel their patients thoroughly, but 38 (39%) patients reported that they received adequate information.ConclusionNT screening is often performed without patients’ full understanding of the implications of potential results and may cause anxiety. Providers should elicit patients’ preferences regarding prenatal testing and engage them in shared decision making about whether to undergo screening, particularly when abortion is not an option. |
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Keywords: | Chile Down syndrome First trimester screening Informed choice Nuchal translucency |
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