Women's opinions and the implications of first- versus second-trimester screening for fetal Down's syndrome

Kornman, Louise; Wortelboer, M. J. M.; Beekhuis, J. R.; Morssink, L. P.; Mantingh, A.

doi:10.1002/(sici)1097-0223(199711)17:11<1011::aid-pd193>3.0.co;2-1

Cited by 68 publications

(52 citation statements)

References 34 publications

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“…A ll 52 studies included in this section referred to a measure that aimed to understand women's prenatal testing choices; 34 were concerned with Down's syndrome screening, 17,45,48,[51][52][53][54][55][57][58][59][60][61][62][63][64][65]75,[81][82][83][84]86,[112][113][114][115][116][117][118][119][120][121][122] and 18 with prenatal carrier testing. 89,90,92,94,[96][97][98][99][100][101][102][103][104]107,[123]…”

Section: Part Two: Other Antenatal Genetic Screening Programmesmentioning

confidence: 99%

“…Fifteen papers assessed cognitions associated with just one of the possible screening options, such as those that accepted screening only or only those that decided to have a diagnostic test. Most studies employed questionnaire or interview survey methods to explore women's choices, seven administered before the testing decision was made, 89,94,96,97,123,124,126 nine after testing but before receipt of results 17,45,48,90,92,107,113,115,125 and the rest after receipt of results. These variations in research design mean it is likely that many findings about cognitions during decision making were prone to some bias, either representing the cognitions associated with just one aspect of the screening process or reporting cognitions that are in some way 'readjusted' postdecision-making.…”

Section: Part Two: Other Antenatal Genetic Screening Programmesmentioning

confidence: 99%

“…Twenty-one studies elicited women's views on the value of prenatal screening, 12 for chromosomal disorders 52,53,55,57,59,60,64,113,114,117,119,121 and nine for carrier testing. 80,90,92,94,96,98,102,124,125 About 80% of women preferred to have the screening option to just the diagnostic test alternative 64,119 and would consider paying for these services.…”

Section: Do Women Want Prenatal Testing?mentioning

confidence: 99%

See 2 more Smart Citations

Psychosocial aspects of genetic screening of pregnant women and newborns: a systematic review

Green

Hewison²,

Bekker³

et al. 2004

Health Technol Assess

262

254

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Section: Part Two: Other Antenatal Genetic Screening Programmesmentioning

confidence: 99%

Section: Part Two: Other Antenatal Genetic Screening Programmesmentioning

confidence: 99%

Section: Do Women Want Prenatal Testing?mentioning

confidence: 99%

See 1 more Smart Citation

Psychosocial aspects of genetic screening of pregnant women and newborns: a systematic review

Green

Hewison²,

Bekker³

et al. 2004

Health Technol Assess

262

254

View full text Add to dashboard Cite

show abstract

“…The examinations were performed by 46 midwives with median 11 (interquartile range, [5][6][7][8][9][10][11][12][13][14][15][16][17] years' experience of mid-gestation routine ultrasound examinations. Before the study started, all the midwives had qualified for a certificate of competence in the theory and practice of the 11-14-week scan including NT measurement from The Fetal Medicine Foundation (FMF), London, UK.…”

Section: The Screening Proceduresmentioning

confidence: 99%

Screening for Down syndrome based on maternal age or fetal nuchal translucency: a randomized controlled trial in 39 572 pregnancies

Saltvedt

Almström

Kublickas

et al. 2005

Ultrasound in Obstet & Gyne

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“…135,136 Despite inevitable anxiety about test results, maternal screening does not appear to cause serious psychological harm to most women. 137 Although high detection rates are important for women who consider themselves to be at high risk, a low false-positive rate is most desirable among women who consider themselves to be at low risk.…”

Section: Will First-trimester Screening Be Accepted By Patients?mentioning

confidence: 99%

Sonographic screening for fetal aneuploidy: first trimester.

Souter¹,

Nyberg²

2001

J of Ultrasound Medicine

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Objectives. Screening for fetal aneuploidy is now possible during the first trimester using sonographic and biochemical markers. The aim of this review was to summarize the efficacy and use of nuchal translucency in screening for fetal aneuploidy, especially fetal Down syndrome, and other anomalies. Methods. We reviewed available literature regarding first-trimester screening. This includes more than 16 studies of nuchal translucency as a marker for fetal aneuploidy published since 1995. Results. Although early studies showed wide variation in detection of fetal Down syndrome when using nuchal translucency, more recent studies showed sensitivities of approximately 70% to 80%, for a 5% false-positive rate. Increased nuchal translucency has also been found to be a marker for other aneuploidies, including trisomy 18, trisomy 13, and Turner syndrome. Maternal serum biochemical screening can be used as a test for aneuploidy during the first trimester. The 2 maternal serum markers that appear to be most useful in the late first trimester are the free β subunit of human chorionic gonadotropin and pregnancy-associated plasma protein A. Together with maternal age, these markers yield a detection rate for trisomy 21 of approximately 60%, for a 5% false-positive rate. Because sonographic and biochemical markers appear to be largely independent, their combined risk results in improved detection rates compared with either method alone. As a result, the combination of nuchal translucency, biochemical markers, and maternal age has achieved a detection rate of approximately 85%, for a 5% false-positive level for detection of trisomy 21. A newly proposed "integrated" approach using a panel of first-and second-trimester markers suggests that further improvement in the screening performance is possible. A number of questions regarding first-trimester screening remain. We address some of these questions: Is first-trimester screening more effective than second-trimester screening? How to account for intrauterine lethality? Is earlier diagnosis important, and will it be accepted by patients? Is first-trimester screening cost-effective? How should first-trimester screening be interpreted with second-trimester tests? Conclusions. Despite encouraging data and general enthusiasm for first-trimester screening for fetal Down syndrome and other aneuploidies, a number of questions remain about its implementation in the United States. Multicenter studies currently under way should help answer some of these questions.

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Women's opinions and the implications of first- versus second-trimester screening for fetal Down's syndrome

Cited by 68 publications

References 34 publications

Psychosocial aspects of genetic screening of pregnant women and newborns: a systematic review

Psychosocial aspects of genetic screening of pregnant women and newborns: a systematic review

Screening for Down syndrome based on maternal age or fetal nuchal translucency: a randomized controlled trial in 39 572 pregnancies

Sonographic screening for fetal aneuploidy: first trimester.

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