Determination the preferences of pregnant women for management in intermediate results of the first trimester screening for aneuploidy after informed consent to them and its relative factors

Abstract

In pregnant women, there is also the concern that ethical issues during screening can lead to the impossibility of terminating the pregnancy when the test result is impaired. In most cases, the general belief is that screening can lead to unnecessary worry or anxiety in women because it can increase or decrease the possibility of a disorder in the fetus. The purpose of this study is to determine the selection method of borderline-risk patients in the first-trimester screening for chromosomal disorders after providing them with written and colloquial information and its relationship with demographic factors and patients' anxiety. Materials and Methods: In this cross-sectional study, pregnant women who were referred with the result of the first-trimester screening for the borderline chromosomal disorder were included in the study based on the inclusion and exclusion criteria. First, the questionnaire on demographic factors and the level of perceived stress and the level of anxiety (Spielberg Questionnaire) were filled out for the patients and then they were consulted and the advantages and disadvantages of each of the possible complementary methods (the following) were given to the patient and, if necessary, his wife. It was explained and a written explanation about different methods for better and easier decision-making was provided to them. Results: In this cross-sectional study, 165 pregnant women who were referred with the first-trimester screening result of borderline chromosomal disorder were included in the study. Based on the results of the first-trimester screening for chromosomal disorders, the patients were divided into two groups, including high risk (1.10 to 1.250) and low risk (1.251 to 1.500), of which 118 cases (71.5%) were in the group. high risk and 47 cases (28.5%) were in the low-risk group. The average age of the women was 36.58 ± 5.59 years and the most common place of their referral was a gynecologist (87.9%). In the comparison of demographic variables, socio-economic findings, history of pregnancy, complications of previous pregnancy, and underlying diseases, no statistically significant difference was observed between the two groups (p>0.05). Also, there was no difference in the findings of the last ultrasound (gestational age, CRL size, and NT level) between high and low-risk patients (p>0.05). In the comparison of two high and low-risk groups in terms of additional selection methods, the frequency of second-trimester screening (23.4 vs. 5.1%; p=0.001) and NIPT test (42.5 vs. 10.2%; p=0.001) was higher in the low-risk group, and the frequency of choosing amniocentesis (81.3 vs. 27.6%; p=0.001) was significantly higher in the high-risk group. The highest frequency of choice of supplementary test in all patients was related to amniocentesis (66.1%). In addition, the most frequent reason for choosing second-trimester screening is related to lower cost (64.7%), the reason for choosing the NIPT test is related to higher sensitivity (68.8%), and the reason for choosing amniocentesis is related to 100% diagnosis (75.2%).