Non-invasive prenatal Down syndrome screening "affordable" in Canada

This is the fourth in a series of papers. The previous papers inform midwifery practice by providing insight into whether, to what extent and how cognitive status influences understanding of Down syndrome screening information, the importance of tailoring information, and highlighting areas of communication that are effective in facilitating understanding. These findings led to the development of recommendations to inform a ‘best practice’ model for midwifery communication of screening information within a conceptual framework that recognises the importance of accurate facts, empathic communication and support for decision-making in a woman-centred approach. These recommendations may have wider relevance beyond midwife communication of Down syndrome screening and may impact upon the communication of other screening information provided within antenatal and neonatal screening. It is important that screening information is communicated effectively in light of changes to screening programmes, such as the introduction of non-invasive prenatal testing.

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Influence of midwife communication on women's understanding of Down syndrome screening information

British Journal of Midwifery ◽

10.12968/bjom.2019.27.12.768 ◽

2019 ◽

Vol 27 (12) ◽

pp. 768-779 ◽

Cited By ~ 1

Author(s):

Sophie John ◽

Maggie Kirk ◽

Emma Tonkin ◽

Ian Stuart-Hamilton

Keyword(s):

Down Syndrome ◽

Mixed Methods ◽

Thematic Analysis ◽

Prenatal Testing ◽

Mixed Methods Design ◽

Screening Practice ◽

Non Invasive ◽

Qualitative Thematic Analysis ◽

The Uk ◽

Down Syndrome Screening

Aim To analyse how midwives communicate Down syndrome screening information and explore whether women's understanding of this information is influenced by midwives' communicative style. Methods Midwives (n=16) and women (n=100) were recruited from a regional NHS unit in the UK. A mixed-methods design encompassed two components; audio-recorded antenatal consultations to assess midwives' communication and quantitative surveys to assess women's understanding. Findings Midwife communication was not significantly related to women's understanding of Down syndrome screening information. However, qualitative thematic analysis revealed midwife communication was often insufficient in fully describing Down syndrome and screening. Communication was not very interactive, midwives dominated conversations and did not sufficiently check women's knowledge/understanding. Conclusions Policymakers need to consider these findings. Deficits in midwife communication in relation to established screening practice needs to be addressed through additional training ahead of full implementation of non-invasive prenatal testing into midwifery practice.

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Is there any effect of fetal gender on the markers of first trimester Down syndrome screening

Zeitschrift für Geburtshilfe und Neonatologie ◽

10.1055/s-0029-1222860 ◽

2009 ◽

Vol 213 (S 01) ◽

Author(s):

GO Ajayi

Keyword(s):

Down Syndrome ◽

First Trimester ◽

Fetal Gender ◽

Down Syndrome Screening

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A technical and clinical evaluation of the new ThermoFisher BRAHMS unconjugated estriol and inhibin-A assays and their use in second trimester Down syndrome screening

Scandinavian Journal of Clinical and Laboratory Investigation ◽

10.1080/00365513.2021.1929439 ◽

2021 ◽

pp. 1-8

Author(s):

Daljit Singh Sahota ◽

Fanny Ho Kau Tsang ◽

Jia Shi Gu ◽

Wai Kei Vicky Fung ◽

Kit Yee Mok ◽

...

Keyword(s):

Down Syndrome ◽

Clinical Evaluation ◽

Second Trimester ◽

Inhibin A ◽

Unconjugated Estriol ◽

Down Syndrome Screening

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Routinization of prenatal screening with the non-invasive prenatal test: pregnant women’s perspectives

European Journal of Human Genetics ◽

10.1038/s41431-021-00940-8 ◽

2021 ◽

Author(s):

Karuna R. M. van der Meij ◽

Annabel Njio ◽

Linda Martin ◽

Janneke T. Gitsels-van der Wal ◽

Mireille N. Bekker ◽

...

Keyword(s):

Down Syndrome ◽

Pregnant Women ◽

Prenatal Screening ◽

Screening Program ◽

Informed Choice ◽

Aneuploidy Screening ◽

Non Invasive ◽

Fetal Aneuploidy ◽

Societal Pressure ◽

Prenatal Test

AbstractDue to the favorable test characteristics of the non-invasive prenatal test (NIPT) in the screening of fetal aneuploidy, there has been a strong and growing demand for implementation. In the Netherlands, NIPT is offered within a governmentally supported screening program as a first-tier screening test for all pregnant women (TRIDENT-2 study). However, concerns have been raised that the test’s favorable characteristics might lead to uncritical use, also referred to as routinization. This study addresses women’s perspectives on prenatal screening with NIPT by evaluating three aspects related to routinization: informed choice, freedom to choose and (personal and societal) perspectives on Down syndrome. Nationwide, a questionnaire was completed by 751 pregnant women after receiving counseling for prenatal screening. Of the respondents, the majority (75.5%) made an informed choice for prenatal screening as measured by the multidimensional measure of informed choice (MMIC). Education level and religious affiliation were significant predictors of informed choice. The main reason to accept screening was “seeking reassurance” (25.5%), and the main reason to decline was “every child is welcome” (30.6%). The majority of respondents (87.7%) did not perceive societal pressure to test. Differences between test-acceptors and test-decliners in personal and societal perspectives on Down syndrome were found. Our study revealed high rates of informed decision-making and perceived freedom to choose regarding fetal aneuploidy screening, suggesting that there is little reason for concern about routinization of NIPT based on the perspectives of Dutch pregnant women. Our findings highlight the importance of responsible implementation of NIPT within a national screening program.

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