Ultrasound screening for chromosomal abnormality: Women's reactions to false positive results
Ultrasound screening for chromosomal abnormality: Women's reactions to false positive results
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DOI：
10.1348/135910700168991
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发表时间：
2000-11-01
影响因子：
7.9
通讯作者：
Mason, G
中科院分区：
文献类型：
--
作者：
Baillie, C;Smith, J;Mason, G
目标。超声波扫描已经成为产前检查的常规部分。最近的发展意味着超声波已经超越了监测怀孕和诊断重大异常的范围。它现在的常规用途包括筛查微小的胎儿异常和染色体异常的迹象。不幸的是，超声波筛查染色体异常的阳性预测值很低(类似于孕妇血清筛查)，只有大约2%的被认定为高危的孕妇会被诊断为染色体异常。其他98%的“高风险”结果被称为“假阳性”。本文的目的是阐明女性对这些结果的主观体验的范围。所采用的方法是解释性现象学分析。在超声结果为假阳性后，对24名孕妇进行了半结构化访谈。对其进行了定性分析。结果。参与者认为超声波扫描主要是一种社交的、非医学的事件，对扫描引起的结果毫无准备。三分之二的人描述了即使在已知正常诊断结果后仍有焦虑的感觉，有时将其归因于对胎儿异常的持续恐惧，但更多地归因于一种普遍的感觉，即可能发生其他意想不到的事情威胁怀孕。这篇论文指出了妇女接受超声波筛查的经历和知情选择的目的之间的重大差异。我们建议应考虑提供有关筛查的医学目的和可能的结果的信息。这项研究还指出，可能需要为大多数女性提供咨询支持，这样她们才能得到阴性诊断的确认，咨询旨在帮助女性重新适应“低风险”怀孕。
Objective. Ultrasound scans have become a routine part of antenatal cart. Recent developments have meant that ultrasound has gone beyond monitoring the pregnancy and diagnosis of major abnormalities. Its routine use now includes screening for subtle fetal abnormalities and indications of chromosomal abnormality. Unfortunately ultrasound screening For chromosomal abnormalities has a low positive predictive value (similar to maternal serum screening), and only about 2% of pregnancies identified as 'high risk' will be diagnosed with a chromosomal abnormality. The other 98% of 'high risk' results are termed 'false positive'. The aim of this paper is to elucidate the range of subjective experiences of women in response to having these results.Method. The approach employed was interpretative phenomenological analysis. Semi-structured interviews were carried out with 24 pregnant women after `false positive' ultrasound results. These were subjected to a qualitative analysis.Results. Participants perceived the ultrasound scan primarily as a social, non-medical event and were unprepared for the result the scan elicited. Two-thirds described residual feelings of anxiety even alter normal diagnostic results were known, sometimes attributed tu continued fears about fetal abnormality, but more often attributed to a generalized feeling that something else unexpected could happen to threaten the pregnancy.Conclusions. The paper has pointed to important discrepancies in the experiences of women undergoing ultrasound screening and the aims of informed choice. We would suggest consideration should be given to providing information on both the medical purposes of screening and on possible outcomes from it. The study also points to the possible need for counselling support for the majority of women who so on to receive confirmation of a negative diagnosis, counselling addressed at helping women to readjust to having a 'low risk' pregnancy.