The Society of Obstetricians and
Gynecologists of Canada has recently published guidelines
recommending access to non-invasive screening for all
pregnant Canadian women. The advantage of significantly
reducing the number of amniocenteses and the overall
fetal losses is well established. "New prenatal screening
guidelines spark row" on page 32 describes another aspect
of prenatal screening: counselling.
Moving away from the test to the
patient, the SOGC guideline authors underline the need
for non-directive counselling. The process of screening
can be very stressful to patients, and a clear understanding
of the implications of the screening test, the meaning
of a decreased or an increased risk for fetal aneuploidy,
and the possible access to invasive testing have to
be discussed before performing the test. With proper
information and support, it's possible to ensure that
participation is voluntary.
More important is to see what future
parents understand from all this information. Listening
to patients and assisting them in finding what they
want is essential. One needs to take the time to do
it, and do it well.
Equal access to proper and respectful
non-directive counselling should be an essential part
of all prenatal screening programmes. The healthcare
providers participating in such programmes should show
respect for individuals with special needs. Non-invasive
screening helps future parents make choices. As physicians,
we need to ensure that these decisions are based on
non-biased and balanced information.
Dr Valérie
Désilets, MD, FRCSC, FCCMG
Obstetrician and medical geneticist,
Hôpital Sainte-Justine, Montréal, QC
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