title: Patient-centered prenatal counseling: aligning obstetric healthcare professionals with needs of pregnant women.
abstract: The first trimester aneuploidy screen (FTS) continues to be a leading approach to identify the risk of fetal aneuploidy. This study evaluated how obstetric (OB) professionals counsel women about FTS as one of a growing number of options to assess fetal health. A survey was completed by OB professionals (board-certified obstetrician/gynecologists and certified nurse midwives) between February and March 2011: (1) to identify knowledge and practice patterns with regard to FTS, and (2) to compare pregnant women's educational needs and decision-making preferences with clinicians' perceptions of these factors. A total of 216 surveys (11 percent) were completed by OB professionals and analyzed. Several barriers to effective patient counseling were identified, including gaps in obstetric professionals' mastery of the screening test characteristics and variable approaches to discuss concepts of aneuploidy risk. OB participants reported limited confidence in discussing patient-valued topics, specifically post-screen options and pregnancy termination. Discordance was identified between OB professionals' perceptions of pregnant women's educational needs and decision-making preferences specific to FTS and historical data recently collected from 139 pregnant women who underwent the FTS. Study findings illustrate the need for clinician-targeted strategies to support pregnant women as they formulate informed decisions about the tests that may have a salient impact on their prenatal care decisions.
authors: a Department of Obstetrics and Gynecology , Cleveland Clinic , Cleveland , Ohio , USA.
authors: Ruth M
authors: RM
authors: Farrell
authors: Benjamin
authors: B
authors: Nutter
authors: Patricia K
authors: PK
authors: Agatisa
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D004314:Down Syndrome / Q000175:diagnosis; D005260:Female; D005817:Genetic Counseling; D005820:Genetic Testing; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D008875:Middle Aged; D048208:Nuchal Translucency Measurement; D009774:Obstetrics; D018802:Patient-Centered Care; D010820:Physicians; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D037841:Pregnant People; D011295:Prenatal Care; D011296:Prenatal Diagnosis / Q000379:methods; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers
keywords: genetic testing; prenatal care; reproductive health