title: Patient and provider attitudes toward screening for Down syndrome in a Latin American country where abortion is illegal.
abstract: OBJECTIVE
  To examine patient and provider attitudes toward first trimester nuchal translucency (NT) screening for Down syndrome and to assess how patients consent to screening in a country where abortion is illegal.
  
  
  METHODS
  Patients presenting for first trimester ultrasound including NT screening in two obstetric units in Chile completed a questionnaire about their attitudes toward NT screening and perspectives on the consent process. A follow-up questionnaire assessed satisfaction with the test. Prenatal care providers also completed a questionnaire ascertaining their perspectives on NT screening.
  
  
  RESULTS
  A total of 107 patients completed the initial questionnaire and 78 completed the follow-up questionnaire. Although 98 (94%) patients desired NT screening only 38 (38%) indicated that they would undergo diagnostic testing if they received screen positive results. Only 3 patients screened positive; however, 15 (20%) participants experienced increased anxiety after the test. Almost all of the 36 providers surveyed indicated that they counsel their patients thoroughly, but 38 (39%) patients reported that they received adequate information.
  
  
  CONCLUSIONS
  NT screening is often performed without patients' full understanding of the implications of potential results and may cause anxiety. Providers should elicit patients' preferences regarding prenatal testing and engage them in shared decision making about whether to undergo screening, particularly when abortion is not an option.
authors.affiliation: Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois, USA. amy.wong@gmail.com
authors.forename: Amy E
authors.initials: AE
authors.lastname: Wong
authors.forename: Miriam
authors.initials: M
authors.lastname: Kuppermann
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Creasman
authors.forename: Waldo
authors.initials: W
authors.lastname: Sepulveda
authors.forename: Juan E
authors.initials: JE
authors.lastname: Vargas
mesh_terms: D000024:Abortion, Illegal; D000328:Adult; D001007:Anxiety / Q000209:etiology; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002677:Chile; D003657:Decision Making; D004314:Down Syndrome / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D048208:Nuchal Translucency Measurement / Q000379:methods / Q000523:psychology*; D010353:Patient Education as Topic / Q000592:standards; D010358:Patient Participation; D017060:Patient Satisfaction; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods; D011795:Surveys and Questionnaires; D055815:Young Adult