title: First-trimester screening and its impact on uptake of diagnostic testing.
abstract: OBJECTIVE
  To determine the influence of first-trimester screening (FTS) on a patient's decision regarding prenatal diagnostic testing (PDT) and if the uptake rate of PDT has changed among women with advanced maternal age (AMA) following the January 2007 American College of Obstetricians and Gynecologists statement regarding FTS.
  
  
  METHODS
  A database review was performed for the 2 years before and the 2 years after the January statement. A total of 7424 patient records were evaluated to determine the number of AMA women who obtained PDT, the number of positive and negative FTS results, and how many of those women had PDT. We then surveyed 53 patients and 23 referring physicians to determine what the patient understands about FTS, how patients utilize their FTS results, and how physicians educate their patients about FTS.
  
  
  RESULTS
  We determined that there was a 19.6% decrease in the uptake of PDT since that statement. Prior to their counseling session (2009-2010), 43% of those surveyed were against having PDT. After counseling, only 9% were against PDT. Overall, 91% were either open to or wanted PDT after counseling.
  
  
  CONCLUSIONS
  In addition to FTS results, we found that genetic counseling may be an influential factor in the patient's decision regarding PDT.
authors.affiliation: Department of Pediatrics, University of Texas-Houston Medical School, Houston, TX, USA. darnes.deanna@tchden.org
authors.forename: Deanna R
authors.initials: DR
authors.lastname: Darnes
authors.forename: Syed
authors.initials: S
authors.lastname: Hashmi
authors.forename: Manju
authors.initials: M
authors.lastname: Monga
authors.forename: Cathy
authors.initials: C
authors.lastname: Sullivan
authors.forename: Alex
authors.initials: A
authors.lastname: Vidaeff
authors.forename: Pamela
authors.initials: P
authors.lastname: Berens
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Czerwinski
mesh_terms: D000328:Adult; D000649:Amniocentesis; D015193:Chorionic Villi Sampling; D005260:Female; D005817:Genetic Counseling; D005820:Genetic Testing; D005865:Gestational Age; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008423:Maternal Age; D010819:Physician's Role; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011296:Prenatal Diagnosis / Q000523:psychology / Q000706:statistics & numerical data*