6 responses to “Early prenatal screening”

  1. I have several questions: 1.What are the options available to the parents if this 1st trimester screening indicate gross abnormalities in the fetus ? 2.How would the parents be counselled ? 3.What are the more common options the parents would decide on ?
    If finding gross abnormalities is unlikely going to affect the ultimate decisions of the parents on learning of the finding of abnormalities with their fetus, then why bother doing these expensive tests and induce more anxiety or mental & ethical dilema and agony for the parents ?

  2. Dr. Seethram,

    Thank you for this well informed info bite. I struggle practicing in BC with the politics that surround this issue. I believe all women should have the right/access to this service and the right to decline it as well. As it stands, only well educated, wealthy women get their options early.

    Dr. Anne Dobson (ob/gyn)

  3. I thought that first trimester screening was just that….screening. You don’t discuss the need for confirmatory testing ie amnio, since the window for CVS is past by 12 weeks. Do you not consider this important?

  4. To answer some of the questions:

    Q: What are the options available to the parents if this 1st trimester screening indicates gross abnormalities in the fetus?
    [Dr. Ken Seethram] If gross abnormalities are seen, including anatomic defects, patients could elect to proceed with CVS or directly to termination.

    Q: How would the parents be counselled ?
    [Dr. Ken Seethram] Full genetic counseling is required for parents, but full ranges of options are given.

    Q: What are the more common options the parents would decide on?
    [Dr. Ken Seethram] The most common options are CVS and amniocentesis

    Q: If finding gross abnormalities is unlikely going to affect the ultimate decisions of the parents on learning of the finding of abnormalities with their fetus, then why bother doing these expensive tests and induce more anxiety or mental & ethical dilemma and agony for the parents?
    [Dr. Ken Seethram] Its very different to find t18 at 12 weeks versus 20weeks. The psychological ramifications of a 20 week induction of pregnancy, versus a 12 week termination are entirely different, and may have very different risks for future reproduction.

    Q: I thought that first trimester screening was just that….screening. You don’t discuss the need for confirmatory testing ie amnio, since the window for CVS is past by 12 weeks. Do you not consider this important?
    [Dr. Ken Seethram] Well, the scans are ideally booked for 12w, such that if risks are elevated, and the patient decides, a CVS can be performed. You are right – all this is just screening, – it is the difficult job of genetic counseling afterwards to ensure that diagnostic testing is reviewed and risks disclosed in full detail.

  5. This should be available for all pregnant women in BC. I appreciate all of Dr. Seethram’s efforts in educating health care providers of the benefits of 1st trimester screening.

  6. “If finding gross abnormalities is unlikely going to affect the ultimate decisions of the parents on learning of the finding of abnormalities with their fetus, then why bother doing these expensive tests and induce more anxiety or mental & ethical dilemma and agony for the parents?”

    As a mother choosing these tests, early results would give me more time to learn about what having a baby with one of these issues would mean. I would have more time to access support for after the birth, to learn about family support groups, access counseling and identify friends and family who can help through the difficult adjustments to what life with a diagnoses like this will mean. I would have more time to learn about the issues that I am likely to deal with. I would have more time to grieve the child I otherwise expected and come to begin to accept the child I am having as he or she is.

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