Decision-Making after Ultrasound Diagnosis of Fetal Abnormality

被引:55
作者
Bijma, Hilmar H. [1 ]
van der Heide, Agnes [2 ]
Wildschut, Hajo I. J. [1 ]
机构
[1] Erasmus Univ, Med Ctr, Dept Obstet & Gynaecol, Rotterdam, Netherlands
[2] Erasmus Univ, Med Ctr, Dept Publ Hlth, Rotterdam, Netherlands
关键词
fetal abnormality; prenatal screening; ultrasound; parental decision-making; end-of-life decisions;
D O I
10.1016/S0968-8080(08)31372-X
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
During the last few decades, the use of ultrasonography for the detection of fetal abnormalities has become widespread in many industrialised countries. This resulted in a shift in timing of the diagnosis of congenital abnormalities in infants from the neonatal period to the prenatal period. This has major implications for both clinicians and the couples involved. In case of ultrasound diagnosis Of fetal anomaly there are several options for the obstetric management, ranging from standard care to non-aggressive care to termination of pregnancy This essay explores the context of both clinical and parental decision-making after ultrasound diagnosis of fetal abnormality, with emphasis on the Dutch situation. While normal findings at ultrasound examination hove strong beneficial psychological effects on the pregnant woman and her partner, the Couple are often ill-prepared for bad news about the health of their unborn child in the case of abnormal findings. When parents consider end-of-life decisions, they experience both ambivalent and emotional feelings. On the one hand, they are committed to their pregnancy; on the other hand, they wont to protect their child, themselves and the family from the burden of severe disability These complex parental reactions hove implications for the counselling strategy. (c) 2007 Springer. All rights reserved.
引用
收藏
页码:82 / 89
页数:8
相关论文
共 56 条
  • [1] Multidisciplinary management of fetal surgical anomalies: The impact on maternal anxiety
    Aite, L
    Trucchi, A
    Nahom, A
    Spina, V
    Bilancioni, E
    Bagolan, P
    [J]. EUROPEAN JOURNAL OF PEDIATRIC SURGERY, 2002, 12 (02) : 90 - 94
  • [2] Bjorkhem G, 1997, J Matern Fetal Med, V6, P87
  • [3] Bosma J M, 1996, Ned Tijdschr Geneeskd, V140, P605
  • [4] 6-year experience of prenatal diagnosis in an unselected population in Oxford, UK
    Boyd, PA
    Chamberlain, P
    Hicks, NR
    [J]. LANCET, 1998, 352 (9140) : 1577 - 1581
  • [5] Bricker L, 2000, HEALTH TECHNOL ASSES, V4, P1
  • [6] Devastation and relief: conflicting meanings of detected fetal anomalies
    Britt, DW
    Risinger, ST
    Mans, MK
    Evans, MI
    [J]. ULTRASOUND IN OBSTETRICS & GYNECOLOGY, 2002, 20 (01) : 1 - 5
  • [7] CAMPBELL S, 1972, LANCET, V2, P1226
  • [8] ROUTINE PRENATAL ULTRASOUND SCREENING FOR FETAL ABNORMALITIES - 22 YEARS EXPERIENCE
    CARRERA, JM
    TORRENTS, M
    MORTERA, C
    CUSI, V
    MUNOZ, A
    [J]. ULTRASOUND IN OBSTETRICS & GYNECOLOGY, 1995, 5 (03) : 174 - 179
  • [9] Chervenak FA, 2003, OBSTET GYNECOL SURV, V58, P473
  • [10] NONAGGRESSIVE OBSTETRIC MANAGEMENT - AN OPTION FOR SOME FETAL ANOMALIES DURING THE 3RD TRIMESTER
    CHERVENAK, FA
    MCCULLOUGH, LB
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1989, 261 (23): : 3439 - 3440