[Changes in the methods of practitioners of fetal medicine after the Perruche judgement and the law passed on the 4th of March 2002].
OBJECTIVE
The aim of this study was to evaluate the effect of the "Perruche case" and that of law issued on the 4th of March 2002 in order to moderate the effect of the case on the daily practice of prenatal diagnosis and fetal medicine.


METHODS
We sent questionnaires to the 186 sonologists of two French regions. Changes in their daily practice, as well as communication with the parents to-be, teaching, and stake in a discussion about the future of their specialty were evaluated.


RESULTS
We received 54 answers (29%). Diagnosis and prognosis of fetal anomalies have become more difficult to expose than before for 40% of them. Written information as well as medical reports or explanation about ability and limits of ultrasound have been improved, in content for 64% and in use for 42%. For 45% of practitioners, it has become particularly important to carefully chose words used with patients. Some clinicians stopped or limited second (60%) and third (45%) trimester scans. They expressed their need to learn about legal regulations (50%) or improve communication skills (44%). About 60% felt the Perruche case and the subsequent law help to improve reflection about the future of fetal medicine and prenatal scans.


CONCLUSIONS
While the law was poorly perceived by many physicians, it has enabled a careful reorganization and formalization of fetal medicine and particularly prenatal scans. Further debate is needed on the objectives of fetal sonography. Practitioners themselves should initiate this discussion.
Léticée
N
N
Centre de Diagnostic Prénatal et de Médecine Foetale, Institut de Puériculture et de Périnatalogie, 26, boulevard Brune, 75014 Paris. nadia.leticee@tele2.fr
Moutard
M-L
ML
Ville
Y
Y
D000015:Abnormalities, Multiple / Q000175:diagnosis / Q000000981:diagnostic imaging*; D003142:Communication; D004992:Ethics, Medical; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging*; D005602:France; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007883:Legislation, Medical; D008297:Male; D011237:Predictive Value of Tests; D011247:Pregnancy; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D016216:Ultrasonography, Prenatal / Q000941:ethics / Q000592:standards