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Antenatal screening

BMJ 1999; 318 doi: (Published 20 March 1999) Cite this as: BMJ 1999;318:805

Obtaining selective consent to scanning, rather than screening, is possible

  1. Catherine Baillie, Research officer.,
  2. Jenny Hewison, Senior lecturer.
  1. Oxford University Department of Educational Studies, Oxford OX2 6PY
  2. School of Psychology, University of Leeds, Leeds LS2 9JT
  3. Psychology and Genetics Research Group, Guy's Hospital, London SE1 9RT
  4. 15 Lyefield Place, Livingston EH54 6TZ

    EDITOR—McFayden et al stated that first trimester ultrasound screening “should include the accurate presentation of all available information before screening to ensure that consent is truly informed.”1 In 1997 we evaluated the content and readability of the leaflets used in 14 centres offering first trimester nuchal translucency screening using a number of predefined variables.2

    Only one of the leaflets met all of the criteria deemed necessary for an informed choice to be made. Thirteen of the leaflets indicated that ultrasound scanning was used to screen for Down's syndrome and chromosomal abnormalities, although only two leaflets gave any description of the syndrome, and this was limited to “mental handicap.” Few of the leaflets gave information on the sensitivity or specificity of the test, or on interpreting results. Eight mentioned diagnostic testing, and two referred to the option of termination. Nine leaflets explained that nuchal translucency screening was separate from other elements of the early pregnancy scan, and four leaflets indicated that written consent was required.

    The content and readability of the leaflets used to inform women of the aims and limitations of screening for nuchal translucency varied widely but the majority could be considered as failing to meet the criteria for informed choice. Even under conditions of informed choice, however, uptake of ultrasound screening is markedly above that which would be expected for other prenatal screening tests. This high uptake has been attributed to expectant …

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