Perinatal management of trisomy 18: a survey of obstetricians in Australia, New Zealand and the UK
Author(s)
Type
Journal Article
Abstract
Objective
The objective of this study was to explore the attitudes of obstetricians in Australia, New Zealand and the UK towards prenatally diagnosed trisomy 18 (T18).
Method
Obstetricians were contacted by email and invited to participate in an anonymous electronic survey.
Results
Survey responses were obtained from 1018/3717 (27%) practicing obstetricians/gynaecologists. Most (60%) had managed a case of T18 in the last 2 years. Eighty-five per cent believed that T18 was a ‘lethal malformation’, although 38% expected at least half of liveborn infants to survive for more than 1 week. Twenty-one per cent indicated that a vegetative existence was the best developmental outcome for surviving children. In a case of antenatally diagnosed T18, 95% of obstetricians would provide a mother with the option of termination. If requested, 99% would provide maternal-focused obstetric care (aimed at maternal wellbeing rather than fetal survival), whereas 80% would provide fetal-oriented obstetric care (to maximise fetal survival). Twenty-eight per cent would never discuss the option of caesarean; 21% would always discuss this option. Management options, attitudes and knowledge of T18 were associated with location, practice type, gender and religion of obstetricians.
Conclusion
There is variability in obstetricians' attitudes towards T18, with significant implications for management of affected pregnancies. © 2013 The Authors. Prenatal Diagnosis published by John Wiley & Sons, Ltd.
The objective of this study was to explore the attitudes of obstetricians in Australia, New Zealand and the UK towards prenatally diagnosed trisomy 18 (T18).
Method
Obstetricians were contacted by email and invited to participate in an anonymous electronic survey.
Results
Survey responses were obtained from 1018/3717 (27%) practicing obstetricians/gynaecologists. Most (60%) had managed a case of T18 in the last 2 years. Eighty-five per cent believed that T18 was a ‘lethal malformation’, although 38% expected at least half of liveborn infants to survive for more than 1 week. Twenty-one per cent indicated that a vegetative existence was the best developmental outcome for surviving children. In a case of antenatally diagnosed T18, 95% of obstetricians would provide a mother with the option of termination. If requested, 99% would provide maternal-focused obstetric care (aimed at maternal wellbeing rather than fetal survival), whereas 80% would provide fetal-oriented obstetric care (to maximise fetal survival). Twenty-eight per cent would never discuss the option of caesarean; 21% would always discuss this option. Management options, attitudes and knowledge of T18 were associated with location, practice type, gender and religion of obstetricians.
Conclusion
There is variability in obstetricians' attitudes towards T18, with significant implications for management of affected pregnancies. © 2013 The Authors. Prenatal Diagnosis published by John Wiley & Sons, Ltd.
Date Issued
2014-01-01
Date Acceptance
2013-10-01
Citation
Prenatal Diagnosis, 2014, 34 (1), pp.42-49
ISSN
0197-3851
Publisher
John Wiley and Sons
Start Page
42
End Page
49
Journal / Book Title
Prenatal Diagnosis
Volume
34
Issue
1
Copyright Statement
© 2013 The Authors. Prenatal Diagnosis published by John Wiley & Sons, Ltd.
DOI: 10.1002/pd.4249
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original
work is properly cited.
DOI: 10.1002/pd.4249
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original
work is properly cited.
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000329355400007&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Genetics & Heredity
Obstetrics & Gynecology
PRENATAL-DIAGNOSIS
FETAL ANOMALIES
CESAREAN-SECTION
NATURAL-HISTORY
RESPONSE RATES
BIRTH-DEFECTS
UNITED-STATES
MAIL SURVEYS
TRISOMIES 13
CARE
Publication Status
Published
Date Publish Online
2013-10-04