Departments of Bioethics, Cleveland Clinic, Cleveland, OH 44195, USA.
Prenat Diagn. 2011 Dec;31(13):1222-8. doi: 10.1002/pd.2867. Epub 2011 Oct 24.
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.
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.
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%).
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.
早孕期非整倍体筛查给患者教育和知情决策带来了独特的挑战。我们的研究评估了那些接受这种新形式非整倍体筛查的孕妇的决策过程。
使用调查工具评估了在早孕期非整倍体筛查中呈现的女性的决策过程的各个组成部分。衡量了知识和决策过程中的主要因素。
参与者（n=139）对唐氏综合征的病因有一定的了解，但对其认知（65.2%）和身体表现（58.7%）的了解较少。很少有人能够从早孕期筛查结果中确定风险（36.7%）。参与者对羊膜穿刺术（84.2%）比绒毛膜取样（73.4%）更为熟悉，尽管对程序风险的了解较少（分别为 29.5%和 28.1%）。大多数参与者将以下内容列为决策的关键信息：根据测试结果了解自己对妊娠结果的意图（92.4%）、了解绒毛膜取样以评估异常结果（92.0%）以及对终止妊娠的价值观和信念（89.1%）。
早孕期非整倍体筛查为患者和提供者提供了教育和决策基准。随着这种新筛查成为当前产前遗传检测服务的一部分，解决这些障碍非常重要。
