Health care professionals' attitudes about pregnancy termination for different fetal anomalies.

Abstract:

BACKGROUND:Health care professionals (HCPs) may be involved in counselling women after an antenatal diagnosis of various fetal anomalies. Many pregnant women consider termination of pregnancy (TOP) after antenatal diagnosis of various fetal anomalies. Little is known, however, about the attitudes of HCPs regarding TOP for specific antenatal diagnoses. OBJECTIVE:To determine the attitudes and opinions of HCPs in maternal and child health regarding TOP for fetal anomalies of varying severity. METHODS:AN ANONYMOUS QUESTIONNAIRE WAS DISTRIBUTED TO FOUR GROUPS OF HCPS: obstetric residents; paediatric residents; delivery room nurses; and neonatal intensive care nurses. Respondents were asked about TOP if they or their spouse were to receive an antenatal diagnosis for five prenatally diagnosed conditions: trisomy 21; trisomy 18; cleft lip and palate; Turner syndrome; and hypoplastic left heart syndrome. RESULTS:Two hundred eighty HCPs answered the questionnaire (90% response rate). Ten per cent of respondents would not consider TOP under any of the circumstances described. Among those who would consider TOP, they were most likely to do so for trisomy 18 and least likely for cleft lip and palate, and fairly evenly divided among the remaining three conditions (hypoplastic left heart syndrome [65%], trisomy 21 [56%] and Turner syndrome [37%]). Paediatric residents were less likely to choose TOP than other groups and obstetrics residents were most likely. CONCLUSIONS:Attitudes of HCPs toward TOP vary according to prenatally identified condition and professional group. More rigorous analysis should be performed regarding the process of counselling and the impact of HCPs beliefs on parental decisions. HISTORIQUE:Les professionnels de la santé (PS) peuvent conseiller les femmes après un diagnostic anténatal de diverses anomalies fœtales. De nombreuses femmes enceintes envisagent une interruption de grossesse (IdG) après un tel diagnostic. Cependant, on ne sait pas grand-chose des attitudes des PS au sujet des IdG suscitées par des diagnostics anténatals précis. OBJECTIF:Déterminer les attitudes et les opinions de PS qui s’occupent des soins mère-enfant au sujet des IdG suscitées par des anomalies fœtales de diverses gravités. MÉTHODOLOGIE:Les chercheurs ont distribué un questionnaire anonyme à quatre groupes de professionnels de la santé : résidents en obstétrique, résidents en pédiatrie, infirmières en salle d’accouchement et infirmières en soins intensifs néonatals. Ils ont demandé aux répondants s’ils opteraient pour une IdG après qu’eux ou leur conjointe eût reçu un diagnostic anténatal de l’une des cinq pathologies suivantes : trisomie 21, trisomie 18, fissure labiopalatine, syndrome de Turner et hypoplasie du cœur gauche. RÉSULTATS:Deux cent quatre-vingts PS ont répondu au questionnaire (taux de réponse de 90 %). Dix pour cent des répondants n’envisageraient une IdG dans aucune des situations décrites. Les autres étaient plus susceptibles d’y avoir recours en cas de trisomie 18, mais moins en cas de fissure labiopalatine, et ils se répartissaient plutôt également entre les trois autres pathologies (hypoplasie du cœur gauche, 65 %, trisomie 21, 56 %, et syndrome de Turner, 37 %). Les résidents en pédiatrie étaient moins susceptibles d’opter pour les IdG que les autres groupes. Les résidents en obstétrique étaient les plus susceptibles de faire ce choix. CONCLUSIONS:Les attitudes des PS envers l’IdG varient selon la pathologie diagnostiquée pendant la période prénatale et selon le groupe professionnel. Il faudrait effectuer une analyse plus rigoureuse du processus de conseils et des répercussions des convictions des PS sur les décisions parentales.

journal_name

Paediatr Child Health

authors

Janvier A,Couture E,Deschenes M,Nadeau S,Barrington K,Lantos J

doi

10.1093/pch/17.8.e86

subject

Has Abstract

pub_date

2012-10-01 00:00:00

pages

e86-8

issue

8

eissn

1205-7088

issn

1918-1485

journal_volume

17

pub_type

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