Meeting patients' education and decision-making needs for first trimester prenatal aneuploidy screening.
OBJECTIVE
First trimester aneuploidy screening introduces unique challenges to patient education and informed decision-making. Our study assessed the decision-making process among those pregnant patients presenting for this new form of aneuploidy screening.


METHODS
A survey instrument was used to assess components of decision-making among women who presented for first trimester aneuploidy screening. Knowledge and leading factors in the decision-making process were measured.


RESULTS
Participants (n = 139) demonstrated understanding of the etiology of Down syndrome, but less understanding of its cognitive (65.2%) and physical manifestations (58.7%). Few were able to determine risk from first trimester screen results (36.7%). Participants were more familiar with amniocentesis (84.2%) than chorionic villus sampling (73.4%), though less familiar with procedural risks (29.5% and 28.1%, respectively). The majority of participants ranked the following as key information in their decision: knowledge of their intentions about the outcome of the pregnancy based on the test results (92.4%), knowledge of chorionic villus sampling to evaluate an abnormal result (92.0%), and values and beliefs about termination (89.1%).


CONCLUSIONS
First trimester aneuploidy screening generates education and decision-making benchmarks for patients and providers. It is important to address these barriers as this new screen becomes a growing part of current prenatal genetic testing offerings.
Departments of Bioethics, Cleveland Clinic, Cleveland, OH 44195, USA. farrelr@ccf.org
Ruth M
RM
Farrell
Benjamin
B
Nutter
Patricia K
PK
Agatisa
D000029:Abortion, Legal; D000328:Adult; D000782:Aneuploidy; D003430:Cross-Sectional Studies; D003657:Decision Making; D004314:Down Syndrome / Q000175:diagnosis; D005260:Female; D005820:Genetic Testing; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D010353:Patient Education as Topic; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011296:Prenatal Diagnosis / Q000009:adverse effects; D012306:Risk; D011795:Surveys and Questionnaires