Prenatal diagnosis of cerebral malformation with an uncertain prognosis: a study concerning couple's information and consequences on pregnancy.
Fetal ultrasound (FU) is used during almost all pregnancies and makes a large contribution to the identification of fetal malformation. It is particularly difficult to announce a malformation, particularly those affecting the brain, because there are often doubts concerning both the diagnosis and the prognosis.


OBJECTIVE
The aim of this study was to analyze how imaging for prenatal screening is organized and how couples are managed and supported. We concentrated on the procedures used to inform couples: content, method of delivery and consequences.


METHODS
Study amongst large multidisciplinary centers in Paris and the Paris region, by semi-directed interviews using a questionnaire.


RESULTS
We showed that it is difficult to standardize the way in which information is supplied before and after the examination, and that doctors tend to recommend abortion when the prognosis is uncertain.


CONCLUSIONS
These results provide information that will help decision-making concerning a standardized procedure allowing couples to benefit from all the capacities of prenatal screening, particularly when the diagnosis and prognosis are uncertain. There is a need for multidisciplinary teams to support and to accompany the decision concerning whether to have an abortion or to continue the pregnancy.
Moutard
Marie-Laure
ML
Service de Neuropédiatrie, Hôpital saint Vincent de Paul, 82, avenue Denfert-Rochereau, 75674, Paris cedex 14, France. marielaure.moutard@svp.ap-hop-paris.fr
Moutel
Grégoire
G
François
Irène
I
Fauriel
Isabelle
I
Feingold
Josué
J
Ponsot
Gérard
G
Hervé
Christian
C
D000028:Abortion, Induced / Q000523:psychology; D001921:Brain / Q000002:abnormalities*; D003657:Decision Making; D005260:Female; D006801:Humans; D009421:Nervous System Malformations / Q000000981:diagnostic imaging* / Q000523:psychology; D011247:Pregnancy; D011379:Prognosis; D011795:Surveys and Questionnaires; D016216:Ultrasonography, Prenatal; D035501:Uncertainty