Chorionic villi sampling: Women's attitudes

Abstract

To determine the acceptability of chorionic villi sampling (CVS) to women eligible for prenatal diagnosis, we undertook a survey to identify aspects of this new procedure that made it more or less preferable than amniocentesis. All women greater than or equal to 35 years scheduled for amniocentesis were asked to read some detailed descriptive material about amniocentesis and CVS, to rate the importance of the specific differences between procedures, and to indicate which procedure they would prefer, first considering each difference between them independently and then considering all the factors jointly. In the absence of precise estimates of CVS-associated risk at the time of the survey, almost equal proportions preferred amniocentesis and CVS (50.2 and 45.1%, respectively). Risk information was the most important factor to women preferring amniocentesis; the timing of the test or nature of the termination procedure was most important to those preferring CVS. In the hypothetical case where CVS was stipulated to have the same attributable risk as amniocentesis, 82% of respondents would prefer it. However, if the spontaneous abortion rate following CVS was stipulated to be 5% more than the amniocentesis risk, preferences reversed and only 22% would still prefer it. Thus, the data suggest that the ultimate acceptability of the new procedure for women over 35 years seeking prenatal diagnosis will depend on the risk associated with it and underscore the importance of ongoing trials aimed at establishing this risk.

Favorable attitudes toward testing for chromosomal abnormalities via analysis of fetal cells in maternal blood

“…For similar reasons, other researchers have also found that a substantial percentage of women prefer prenatal testing to be conducted in the first trimester. [21][22][23][24] Earlier studies regarding second-trimester MSAFP testing found that women would prefer serum screening, because it would allow a stepwise approach to prenatal diagnosis, despite the limited time frame for decision-making. [25][26][27] Almost all of the women reported that they would have subsequent invasive testing if the maternal blood test returned an abnormal result.…”

Patterns of mood states in pregnant women undergoing chorionic villus sampling or amniocentesis

“…CVS is optimally performed, either transcervically or transabdominally, a t 9 to 12 menstrual weeks. Also, because results from assays of villi can be reported more rapidly, the traditionally difficult aspects of the waiting period may be if not eliminated, at least substantially shortened [Chervin et al, 1977;Golbus et al, 1974;Lippman et al, 1985;Tunis, 1985;Verjaal et al, 19821. Much clinical experience and research support the psychological advantage of shortening the time couples must wait for prenatal diagnosis results.…”

“…A 7-center collaborative investigation was sponsored by the National Institute of Child Health and Human Development (NICHD) beginning in 1985 to examine the safety and accuracy of CVS compared to amniocentesis [Hogge et al, 1985;Lippman et al, 1985;NICHD, 1976;Rhoads et al, 19891. The present paper results from this investigation and describes an empirical comparison of mood states, over the course of pregnancy, of women who had amniocentesis with those who had CVS.…”

Acceptance of First-Trimester Prenatal Diagnosis for the Haemoglobinopathies in Lebanon

“…Premarital screening has been recently made compulsory in Lebanon; however, there are currently no data concerning the effects of genetic counselling and acceptance of prenatal diagnosis in countries such as Lebanon. In fact, most studies have been conducted in North America and Europe and show high levels of uptake of prenatal diagnostic procedures (Modell et al, 1984;Lippman et al, 1985;Perry et al, 1985;McGovern et al, 1986;Cao et al, 1987;Cox, 1987, 1988), but this might not be the case in Middle-Eastern societies, because of different cultural and religious beliefs. Lebanon is a mosaic of different religious communities, of various educational and socioeconomic backgrounds.…”