Seeing baby: women's experience of prenatal ultrasound examination and unexpected fetal diagnosis

Abstract

Objective: Although prenatal ultrasound (US) is a common clinical undertaking today, little information is available about women's experience of the procedure from the perspective of women themselves. The objective of this study was to explore women's experience of undergoing a routine prenatal US examination associated with an unexpected fetal diagnosis.Study Design: Qualitative methods were used to explore the prenatal US experience of 13 women. Five women were given unexpected news of multiple pregnancy and eight women were given unexpected news of congenital fetal abnormality. One in-depth audio-taped interview was conducted with each woman. Content analysis of interview data identified themes common to women's experience of US.Results: Identified themes of women's experience of routine prenatal US examination associated with an unexpected fetal diagnosis are: experiencing the setting, sensing information, feeling connected/ disconnected, the power of the image, and communication rules. Conclusions:Women's experience of prenatal US examination is influenced by physical and environmental factors and by the behaviors of the US examiner. Behaviors of the examiner contribute to a woman's labeling of the US experience as positive or negative. Women identify being objectified by the examination and experience poor communication patterns after a fetal US diagnosis. Women's description of the US screen image as a baby suggests it is a powerful influence on subsequent clinical and ethical decision-making about the pregnancy. Journal of Perinatology (2006Perinatology ( ) 26, 403-408. doi:10.1038 Keywords: prenatal care; sonography; maternal experience; antenatal diagnosis; fetal anomaly Introduction Although routine ultrasound examination (US) in low-risk pregnancy has not been proven to be advantageous in terms of perinatal mortality and morbidity, its use has become standard during pregnancy.1,2 Diagnoses resulting from prenatal US include multiple gestation, congenital fetal abnormalities, fetal growth problems and amniotic fluid or placental abnormalities. Study of US as a perinatal diagnostic tool has focused on whether US improves perinatal outcomes, 3-6 the psychological effect on women and men of such an examination, 7-9 perception and receipt of information, 10-14 and the experiences of staff who perform US examinations.15,16 A 1998 Cochrane review of routine US 17 focused only on physical outcomes, as did a later work. 18Reviewers of the work suggested a lack of research on women's experience of this type of procedure. 19Other researchers have focused on specific aspects of breaking bad news in perinatal situations and the sequelae of such an action. Alkazaleh et al.20 surveyed 117 women with pregnancy complications detected sonographically. Sixty-seven women responded to their survey of broad characteristics of bad news transmission, reporting what women found helpful after being given bad news. These researchers recommend further research into the area of bad news transmission using other research designs....

Ultrasound in Pregnancy: A Cross-sectional Study of Knowledge and Expectations among Pregnant Women in Southwest Turkey

“…This result is similar to that of a Chinese study in which 65% of participants knew that ultrasound was not compulsory (11). Beyond basic diagnostic uses, ultrasound imaging may also have a bonding effect between the mother, partner, and fetus (21), although scans are not necessarily performed at every visit. In Denmark, since the introduction of the Danish National Board of Health guidelines in 2004, all Danish pregnant women have been offered two ultrasound scans, one at 11-14 weeks as a risk evaluation for Down syndrome, and one at 18-20 weeks as a fetal anomaly scan (22).…”

Postnatal follow-up of antenatal hydronephrosis: a health-care challenge

“…[22][23][24] The discovery during a routine US of an anomaly such as ANH produces significant concern, parental anxiety and in many cases, extreme distress. [25][26] Likely, this reaction is tempered by the notion that the majority of ANH cases will resolve spontaneously before or after birth during the first year of life. [3][4]7 For mothers who have been worrying throughout pregnancy, the sight of a healthy looking infant at birth provides some relief that may be short lived if the asymptomatic infant is required to undergo more testing.…”

Kvinners erfaringer i møtet med abortnemnda ved sene svangerskapsbrudd

“…Det finnes noen studier som har sett på hvordan kvinner responderer på informasjonsrutinene i forbindelse med ultralydundersøkelsen (Chrang-Svalenius et al, 1996, Mitchell, 2001, Khoshnood et al, 2006, Van der Zalm and Byrne, 2006. Men det er få studier om ulike måter å gi informasjon på.…”

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