Do pregnant women and their partners make an informed choice about first trimester risk assessment for Down syndrome, and are they satisfied with the choice?

2012 ◽  
Vol 33 (2) ◽  
pp. 146-152 ◽  
Author(s):  
Louise Bangsgaard ◽  
Ann Tabor
Keyword(s):  
Risk Assessment ◽  
Down Syndrome ◽  
Pregnant Women ◽  
Informed Choice ◽  
First Trimester

scholarly journals Routinization of prenatal screening with the non-invasive prenatal test: pregnant women’s perspectives

2021 ◽  
Author(s):  
Karuna R. M. van der Meij ◽  
Annabel Njio ◽  
Linda Martin ◽  
Janneke T. Gitsels-van der Wal ◽  
Mireille N. Bekker ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Pregnant Women ◽  
Prenatal Screening ◽  
Screening Program ◽  
Informed Choice ◽  
Aneuploidy Screening ◽  
Non Invasive ◽  
Fetal Aneuploidy ◽  
Societal Pressure ◽  
Prenatal Test

AbstractDue to the favorable test characteristics of the non-invasive prenatal test (NIPT) in the screening of fetal aneuploidy, there has been a strong and growing demand for implementation. In the Netherlands, NIPT is offered within a governmentally supported screening program as a first-tier screening test for all pregnant women (TRIDENT-2 study). However, concerns have been raised that the test’s favorable characteristics might lead to uncritical use, also referred to as routinization. This study addresses women’s perspectives on prenatal screening with NIPT by evaluating three aspects related to routinization: informed choice, freedom to choose and (personal and societal) perspectives on Down syndrome. Nationwide, a questionnaire was completed by 751 pregnant women after receiving counseling for prenatal screening. Of the respondents, the majority (75.5%) made an informed choice for prenatal screening as measured by the multidimensional measure of informed choice (MMIC). Education level and religious affiliation were significant predictors of informed choice. The main reason to accept screening was “seeking reassurance” (25.5%), and the main reason to decline was “every child is welcome” (30.6%). The majority of respondents (87.7%) did not perceive societal pressure to test. Differences between test-acceptors and test-decliners in personal and societal perspectives on Down syndrome were found. Our study revealed high rates of informed decision-making and perceived freedom to choose regarding fetal aneuploidy screening, suggesting that there is little reason for concern about routinization of NIPT based on the perspectives of Dutch pregnant women. Our findings highlight the importance of responsible implementation of NIPT within a national screening program.

scholarly journals The Effect of Down Syndrome Biochemical Markers on Predicting Severity of Preeclampsia

2020 ◽  
Author(s):  
AYSE OZBAN
Keyword(s):  
Down Syndrome ◽  
Pregnant Women ◽  
Biochemical Markers ◽  
First Trimester ◽  
Maternal Serum ◽  
Screening Tests ◽  
Second Trimester ◽  
Study Results ◽  
Second Trimester Screening ◽  
Trimester Screening

Abstract Objective: This study aims to determine whether it is possible to predict preeclampsia by comparing postpartum results and test results of the pregnant women diagnosed with preeclampsia, whose first and/or second trimester screening tests were accessible, and to demonstrate the predictability of severity and week of onset.Background: 204 patients underwent renal transplantation in our center and 84 of them were female. Five of our patients (one of them had two births) gave birth to a total of 6 pregnancies.Method: 135 patients were diagnosed with preeclampsia and their first and/or second trimester screening tests were accessible, and 366 control participants gave birth to a healthy baby between 37-41 weeks after standard follow-up period for pregnancy and their screening tests were also accessible.Results: The study results show that the first trimester maternal serum PAPP-A level is significantly low in preeclamptic pregnant women, and that the second trimester maternal serum AFP and hCG levels are significantly high and uE3 levels are significantly low The results also suggest that the first and second trimester Down syndrome biochemical markers can be used in preeclampsia screening.Conclusion: Among these markers, uE3 is the parameter which affects the possibility of preeclampsia the most. However, the first and second trimester Down syndrome biochemical markers are not effective in predicting the severity and onset week of preeclampsia.

SHOULD A FIRST-TRIMESTER RISK ASSESSMENT FOR PRE-ECLAMPSIA BE ROUTINELY OFFERED?

2013 ◽  
Vol 24 (2) ◽  
pp. 129-133
Author(s):  
MAURO PARRA-CORDERO
Keyword(s):  
Public Health ◽  
Risk Assessment ◽  
Pregnant Women ◽  
Expert Opinion ◽  
First Trimester ◽  
Good Evidence ◽  
Point Of View ◽  
Health Policies ◽  
Public Health Policies ◽  
First Trimester Of Pregnancy

From a scientific point of view, the answer to the question might be quite straightforward in favour of routinely screening all pregnant women for pre-eclampsia (PE) during the first trimester of pregnancy. However, irrespective of the large amount of good evidence and expert opinion favourable for universally screening for obstetric syndromes, such as PE, public health policies do not always align with pure clinical science.

scholarly journals Relative Risk Assessment of Intrauterine Infection of the Fetus During Cytomegalovirus Infection in Early Pregnancy

2019 ◽  
Vol 4 (3) ◽  
pp. 45-51 ◽  
Author(s):  
K. K. Petrova
Keyword(s):  
Risk Assessment ◽  
Relative Risk ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Intrauterine Infection ◽  
First Trimester ◽  
Cmv Infection ◽  
Significant Difference ◽  
First Trimester Of Pregnancy ◽  
Relative Risk Assessment

Background. Intrauterine fetal infection (IUI), the common cause of which is the cytomegalovirus (CMV), occupies one of the first places in the structure of perinatal morbidity and mortality. There are no data on the relative risk assessment of IUI at the exacerbation of CMV infection and its delitescent course in first trimester of pregnancy in the literature.Aim: to calculate the relative risks of fetal IUI in pregnant women with exacerbation of CMV infection in the first trimester of pregnancy.Methods. A retrospective review of the labor and delivery medical records and prenatal records of 104 CMV-seropositive women was carried out. Fifty of these women had an exacerbation of CMV infection in the first trimester of pregnancy – main group and 54 of them were with delitescent course of the disease (comparison group).Results. A comparative analysis of ultrasound and morphological markers of IUI with risk assessment depending on the course of CMV infection in the first trimester of pregnancy has been carried out. A high risk of placental structure abnormalities, as well as amniotic fluid and fetal membranes, fetal and placental blood flow pathology, onset of  choroid plexus cyst and fetal growth restriction was found, with a statistically significant difference in the group of pregnant women with exacerbation of CMV infection in the first trimester of pregnancy.Conclusion. The findings suggest that the exacerbation of CMV infection in early pregnancy is a risk factor for IUI.

scholarly journals Informed Choice for Participation in Down Syndrome Screening: Development and Content of a Web-Based Decision Aid

2015 ◽  
Vol 4 (3) ◽  
pp. e113 ◽  
Author(s):  
Mette Maria Skjøth ◽  
Helle Ploug Hansen ◽  
Eva Draborg ◽  
Claus Duedal Pedersen ◽  
Ronald F Lamont ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Pregnant Women ◽  
Decision Aid ◽  
Screening Program ◽  
Informed Choice ◽  
Care Providers ◽  
Patient Decision Aid ◽  
Web Based ◽  
Patient Decision ◽  
Down Syndrome Screening

Background In Denmark, all pregnant women are offered screening in early pregnancy to estimate the risk of having a fetus with Down syndrome. Pregnant women participating in the screening program should be provided with information and support to allow them to make an informed choice. There is increasing interest in the use of Web-based technology to provide information and digital solutions for the delivery of health care. Objective The aim of this study was to develop an eHealth tool that contained accurate and relevant information to allow pregnant women to make an informed choice about whether to accept or reject participation in screening for Down syndrome. Methods The development of the eHealth tool involved the cooperation of researchers, technology experts, clinicians, and users. The underlying theoretical framework was based on participatory design, the International Patient Decision Aid Standards (IPDAS) Collaboration guide to develop a patient decision aid, and the roadmap for developing eHealth technologies from the Center for eHealth Research and Disease Management (CeHRes). The methods employed were a systematic literature search, focus group interviews with 3 care providers and 14 pregnant women, and 2 weeks of field observations. A qualitative descriptive approach was used in this study. Results Relevant themes from pregnant women and care providers with respect to information about Down syndrome screening were identified. Based on formalized processes for developing patient decision aids and eHealth technologies, an interactive website containing information about Down syndrome, methods of screening, and consequences of the test was developed. The intervention was based on user requests and needs, and reflected the current hospital practice and national guidelines. Conclusions This paper describes the development and content of an interactive website to support pregnant women in making informed choices about Down syndrome screening. To develop the website, we used a well-structured process based on scientific evidence and involved pregnant women, care providers, and technology experts as stakeholders. To our knowledge, there has been no research on the combination of IPDAS standards and the CeHRes roadmap to develop an eHealth tool to target information about screening for Down syndrome.

scholarly journals P07.01: Patient's perception of first trimester risk assessment for Down syndrome: what is a “high risk” for you?

2012 ◽  
Vol 40 (S1) ◽  
pp. 192-193
Author(s):  
L. Batlle ◽  
G. E. Chalouhi ◽  
N. Mathieu ◽  
N. E. Russell ◽  
J. Stirnemann ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Down Syndrome ◽  
High Risk ◽  
First Trimester ◽  
Patient’S Perception

First-trimester Down syndrome screening in renal-transplanted pregnant women: a model for adjusting the false-positives rates

2013 ◽  
Vol 33 (5) ◽  
pp. 467-470 ◽  
Author(s):  
Maribel Grande ◽  
Vicenç Cararach ◽  
Elena Casals ◽  
Antoni Borrell
Keyword(s):  
Down Syndrome ◽  
Pregnant Women ◽  
First Trimester ◽  
False Positives ◽  
Down Syndrome Screening

scholarly journals Genome-wide miRNA profiling in plasma of pregnant women with Down syndrome fetuses

2019 ◽  
Author(s):  
Iveta Zedníková ◽  
Blanka Chylíková ◽  
Ondřej Šeda ◽  
Marie Korabečná ◽  
Eva Pazourková ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Pregnant Women ◽  
Validation Study ◽  
First Trimester ◽  
Mirna Profiling ◽  
Diagnostic Potential ◽  
Genome Wide ◽  
Study Results ◽  
Common Causes ◽  
Preliminary Study

Abstract ABSTRACT Objective: Down syndrome (DS) belongs to the most common causes of mental retardation in men, therefore new approaches allowing its rapid and effective prenatal detection are being explored. In our study we focused on diagnostic potential of plasma microRNAs. We follow up on our previous study in DS placentas, where seven miRNAs were found as being significantly elevated. Methods: A total of 70 first-trimester plasma samples of pregnant women were included to the present study (35 samples with DS fetuses; 35 with euploid fetuses). The genome-wide miRNA profiling was performed in the preliminary study using Affymetrix GeneChip™ miRNA 4.1 Array Strips. Selected miRNAs were then included to the following validation study using qPCR. Results: Based on the current pilot study results (12 miRNAs), our previous research on CVS samples (7 miRNAs) and literature (4 miRNAs), the group of 23 miRNAs were selected for validation study. Although the results of the preliminary study were promising, the following validation step using more sensitive technology RT-PCR and larger group of samples revealed no significant differences in miRNA profiles between compared groups. Conclusion: Our results suggest that testing of the first trimester plasma miRNAs is not suitable for NIPT. Different results could be theoretically achieved at later gestational ages; however, such a result probably would have limited utilization in clinical practice.

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