An evaluation of the decision-making process regarding amniocentesis following a screen-positive maternal serum screen result

Abstract

Objectives: To identify the decision-making factors and personal characteristics of women who opt for and against amniocentesis following a screen-positive maternal serum screen (MSS) result.

Methods: A questionnaire was mailed to 597 women who were randomly selected among women in the province of British Columbia (BC) who screened positive for Down syndrome (DS) on the MSS between January and June 2005. Subjects were evenly distributed across two main parameters: screen-positive women who opted for, and declined, amniocentesis (Groups 1 and 2, respectively).

Results: Significant differences (P < 0.05) between Groups 1 and 2 include; reasons for wanting the MSS, post-positive MSS anxiety level, risk of miscarriage associated with amniocentesis, MSS risk estimate, reasons for wanting, or not wanting amniocentesis, normal fetal ultrasound, attitudes towards termination and religious beliefs. About half of all women across both groups did not find the MSS helpful in their pregnancy, primarily stating that it caused unnecessary increased anxiety.

Conclusions: To help avoid, or at least prepare women for the likelihood of increased anxiety following a screen-positive MSS result, and help prepare them for decision making, it is important to target MSS counselling to the individuality of the patient, and address these factors before MSS is undertaken.