Roelofsen E E, Kamerbeek L I, Tymstra T J, Beekhuis J R, Mantingh A
Northern Centre for Health Care Research, University of Groningen, The Netherlands.
Prenat Diagn. 1993 Aug;13(8):741-7. doi: 10.1002/pd.1970130808.
We studied the opinions and experiences concerning maternal serum screening of two groups of women: (A) women who were not eligible for prenatal diagnosis; and (B) women for whom prenatal diagnosis was available because of advanced maternal age, and who either underwent chorionic villus sampling or amniocentesis. Many of the women were in favour of the availability of serum screening and would apply for this test in a future pregnancy. This applied also to many respondents who had previously undergone prenatal diagnosis. Most of these women, however, did not intend to decline diagnostic amniocentesis if the screening results did not indicate an increased risk. The majority of the group of respondents of 36 years and over did not consider it acceptable if age indication was dropped altogether. A system based on serum screening will have other implications than a policy based on age indication, since specific individual risk assessment is perceived as being of more significance than a risk statistically derived from age alone. Serum screening is often seen as a means of reassurance and many women are not aware of the possible drawbacks. As technology becomes increasingly complicated, counselling has to be adjusted correspondingly. Further research is needed to establish whether and how distress can be minimized and well-considered individual choice can be achieved.
（A）不符合产前诊断条件的女性；（B）因母亲年龄较大而可进行产前诊断的女性，她们要么接受了绒毛取样，要么接受了羊膜穿刺术。许多女性赞成进行血清筛查，并表示会在未来怀孕时申请此项检查。这也适用于许多之前接受过产前诊断的受访者。然而，这些女性中的大多数表示，如果筛查结果未显示风险增加，她们并不打算拒绝诊断性羊膜穿刺术。36岁及以上的大多数受访者认为，如果完全取消年龄指征是不可接受的。基于血清筛查的系统与基于年龄指征的政策会有不同的影响，因为特定的个体风险评估被认为比仅从年龄统计得出的风险更重要。血清筛查常常被视为一种让人安心的手段，许多女性并未意识到其可能存在的弊端。随着技术变得越来越复杂，咨询也必须相应调整。需要进一步研究以确定是否以及如何将困扰降至最低，并实现经过深思熟虑的个人选择。
