Genetic counseling for fetal abnormalities in a South African community.
Fetal abnormalities are congenital abnormalities identified prenatally. Women who have a fetal abnormality detected often have to make difficult decisions regarding continuation or termination of the pregnancy. The aims of this research project were: to investigate some of the factors that influenced the decision to terminate a pregnancy in which fetal abnormalities were diagnosed; and to determine the implications for genetic counseling practice in South Africa. The study was retrospective and file-based. A total of 171 women counseled for fetal abnormalities, between 2002 and 2006, were identified and relevant data were collected from their records. Altogether 116/170 (68.2%) women were offered termination of pregnancy, and 73/113 (65%) requested the procedure. Early gestation, gestation at the time termination was offered, and ethnicity of the patient, were significantly associated with a termination request. Black patients were less likely to request termination, but more likely to receive a late diagnosis than other patients. Genetic counselors need to adopt an advocacy and educational role to improve this situation. Furthermore, a better understanding of the cultural and ethnicity-related issues is required.
Human Genetics Division, University of the Witwatersrand and National Health Laboratory Service, PO Box 1038, Johannesburg, South Africa.
Caryn
C
Todd
Tabitha
T
Haw
Jennifer
J
Kromberg
Arnold
A
Christianson
D000025:Abortion, Eugenic / Q000523:psychology; D000293:Adolescent; D000328:Adult; D044383:Black People / Q000235:genetics / Q000523:psychology*; D000013:Congenital Abnormalities / Q000175:diagnosis / Q000235:genetics*; D003431:Cross-Cultural Comparison; D003657:Decision Making; D005260:Female; D005817:Genetic Counseling / Q000523:psychology*; D005865:Gestational Age; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D012189:Retrospective Studies; D013019:South Africa; D044465:White People / Q000235:genetics / Q000523:psychology*; D055815:Young Adult