Department of Obstetrics and Gynecology, National Taiwan University Hospital and College of Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Taiwan J Obstet Gynecol. 2010 Mar;49(1):50-6. doi: 10.1016/S1028-4559(10)60009-5.
Respect for patients' autonomy is a principle issue in medical ethics. Patients' understanding of antenatal serum screening for Down syndrome upon informed consent has barely been assessed. Our objective was to evaluate pregnant women's perceived level of understanding of this serum screening.
Pregnant women between the 15(th) and 21(st) gestational week were randomized into control and experimental groups, and were asked to complete a questionnaire before and after genetic counselling provided by researchers. The primary endpoints were the perceived level of understanding of serum screening for Down syndrome and the autonomy of the decision making for this serum screening. The secondary endpoints were the anxiety and depression levels of these women.
Participants in the experimental group (n = 96) had a significantly higher perceived level of understanding of antenatal serum screening for Down syndrome than participants in the control group (n = 97). There were significantly more respondents in the experimental group making the decision themselves to undergo serum screening than women in the control group. Anxiety and depression levels were not significantly different between the women in the two groups.
Pregnant women should be offered more information to allow them to make an informed decision before they undergo antenatal serum screening for Down syndrome. Comprehensive genetic counseling improved pregnant women's autonomy in deciding whether to participate in serum screening. Health service providers should make effort to fulfill the ethical requirements of informed consent.
尊重患者自主权是医学伦理学的一个基本原则。患者对知情同意下的唐氏综合征产前血清筛查的理解几乎没有得到评估。我们的目的是评估孕妇对这种血清筛查的感知理解程度。
将 15 至 21 孕周的孕妇随机分为对照组和实验组，并要求她们在研究人员提供遗传咨询之前和之后完成一份问卷。主要终点是对唐氏综合征产前血清筛查的感知理解程度和对这种血清筛查决策的自主性。次要终点是这些女性的焦虑和抑郁水平。
实验组（n = 96）的孕妇对唐氏综合征产前血清筛查的感知理解程度明显高于对照组（n = 97）。实验组中有更多的受访者自己决定进行血清筛查，而对照组中的女性则较少。两组女性的焦虑和抑郁水平没有显著差异。
在孕妇接受唐氏综合征产前血清筛查之前，应向其提供更多信息，使其能够在知情的情况下做出决定。综合遗传咨询提高了孕妇在决定是否参与血清筛查方面的自主权。卫生服务提供者应努力满足知情同意的伦理要求。
