First trimester ultrasound screening

Carries ethical and psychological implications

Letters p 748

Ultrasound scanning has been an integral part of antenatal care in industrialised countries for some time,1 but until recently detection of fetal abnormalities by this method has been possible only in the second trimester. High resolution scanning during the first trimester is now possible and is routine in some units. Not only chromosomal abnormalities but also structural anomalies can be diagnosed by this means,2 and the advent of such a capability raises both ethical and psychological issues.

While healthcare professionals in maternity services are good at giving some sorts of information to patients—for example, on nutrition during pregnancy—they may fail to consider the issues of informed consent raised by the use of such a powerful diagnostic tool during routine antenatal care. 3 4 Most women being offered these scans are at low risk of fetal abnormality and the scan constitutes their first visual encounter with their baby. They may believe that it will provide information only about gestational age and be unaware of the range of abnormalities that can be detected. Recent research suggests that many women are not told beforehand of …