Abstract
Women of 10 - 14 weeks of pregnancy who were participating in a study of first trimester screening for chromosomal abnormalities were invited to complete a questionnaire. This examined their knowledge about the triple test, perception of risk and views on screening. The response rate was 70.3% (270/384). The mean age of responders was 34.2 years and 47% (127/270) had a child already. Of those between 35 and 39 years 47.6% (40/84) planned to use the triple test to decide about amniocentesis as did 6.9% (2/29) of those of 40 years or more and 50.7% (136/268) of responders overall. When asked what they would do if the fetus had Down syndrome 22.0% (58/264) said they would tenninate the pregnancy, 22.3% (59/264) would continue and 55.7% (147/264) were uncertain. Almost half (47.9%; 126/263) of patients correctly identified the detection rate for the triple test as approximately 65%, 33% underestimated the detection rate and 19% overestimated it. When asked about the false positive rate, 13.0% (32/246) correctly identified it as 1 in 20, 16.7% said 1 in 50, 43% said 1 in 100 and 27.2% said 1 in 1000. Almost all responders (96.9%; 248/256) correctly answered that a woman with a low risk test result could have an affected baby. Over a third (34.4%; 88/256) were unaware that most women with a high risk result have a chromosomally normal baby. Women were asked to estimate their risk for Down syndrome. Responders estimated their risk to be less than half of the age related risk in 35% (89/266) of cases and overestimated it by at least two times in 13%. When asked how they considered their risk: 90% (135/150) under 35 years, 55.3% (47/85) between 35 and 39 years and 20.7% (6/29) of 40 years or more, considered themselves as being “low risk”. In this group most responders planned to use the triple test but most were unsure what they would do with the information. Many perceived their risk to be lower than their age related risk. Almost all were aware that the test was not 100% sensitive but many overestimated the significance of a “high risk” resuK. They also underestimated the false positive rate. Emphasizing these points to women prior to screening may help alleviate some of the distress that is often experienced with false positive results.
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Snow, S., Souter, V., Luthv, D. et al. Preconceived Ideas about Second Trimester Screening: a Guide for Counseling. Genet Med 2, 102 (2000). https://doi.org/10.1097/00125817-200001000-00186
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DOI: https://doi.org/10.1097/00125817-200001000-00186