Serum screening for Down's syndrome: how much do health professionals know?

OBJECTIVE

To assess knowledge about serum screening for Down's syndrome in health professionals involved in antenatal care.

DESIGN

Postal questionnaire survey of knowledge of performance and interpretation of serum screening.

SETTING

Portsmouth and South East Hampshire health district.

POPULATION

All health professionals likely to be involved in antenatal care.

METHODS

Questionnaires were sent to all general practitioners (n = 288), hospital midwives (n = 129), community midwives (n = 71), and obstetricians (n = 29) working in the district.

MAIN OUTCOME MEASURES

Total number of correct responses given to eight factual questions and percentage of correct responses to each individual question.

RESULTS

Responses were received from 434 health professionals (84%). Fifty-nine percent of health professionals correctly answered only a half or less of the factual questions on serum screening. Questions relating to the sensitivity, specificity, and positive predictive value were particularly poorly answered. Obstetricians scored most highly. General practitioners scored significantly less than the other groups.

CONCLUSIONS

Women need accurate information to give informed consent to serum screening. Most health professionals likely to be involved in antenatal care in this district do not fully understand the test and are thus unlikely to provide such information. Changes in the provision of maternity services following Changing Childbirth may increase the input of midwives and general practitioners. Training of professionals about serum screening should be reviewed.