Evaluation of a fetomaternal-surgical clinic for prenatal counselling of surgical anomalies

Abstract

With increasing ability to diagnose fetal anomalies, it is imperative that parents receive appropriate counselling to reach their decision. The aim of this study was to evaluate the fetomaternal-surgical clinic held jointly by an obstetrician and a paediatric surgeon. At this monthly clinic the patients are first scanned by the consultant fetomaternal specialist in the presence of a consultant paediatric surgeon and subsequently counselled jointly in an adjacent quiet room. Other specialists such as geneticist and neonatologists provided further counselling where needed. All 43 parents who attended this clinic in the year 2005 were included in this study and were counselled by the same paediatric surgeon. A questionnaire was designed to assess the different aspects of service provided by this clinic. In this study the diagnosis was changed in 3 (7%) babies, 2 (4.6%) parents miscarried and 1 (2.3%) neonatal death occurred, unrelated to the surgical anomaly. The site of delivery was changed in 20 (48%) patients and the mode of delivery in 7 (10%). All 43 (100%) parents were satisfied with the fetal counselling, eight patients (18.6%) felt increased anxiety post-counselling and 95% had a better understanding of their unborn babies condition after counselling. Two (4.6%) parents decided to terminate the pregnancy due to complex fetal abnormalities, and 31 (72%) felt they understood the future pregnancy risks. Fifty-six per cent of parents felt that further counselling from religious person should be offered.