Abstract
Introduction
Routine prenatal screening ultrasounds primarily serve to diagnose major fetal anomalies which may prompt further testing and inform clinical decision-making, including possible pregnancy termination. Meanwhile, expectant parents may view the ultrasound experience and information gained differently from their clinicians. In this setting, how to best counsel patients, especially regarding the increasing findings of indeterminant clinical significance, is unclear. Greater understanding of women’s views before undergoing their ultrasound may help to guide anticipatory counseling about the purpose of screening and interpretation of results.
Methods
We surveyed 289 patients presenting for scheduled prenatal ultrasounds at an academic tertiary care center. Discrete and open-ended questions assessed views surrounding the receipt of abnormal results and management of the pregnancy once fetal anomalies are detected. Qualitative responses were analyzed using thematic analysis.
Results
Most (95%) desired information about abnormal sonographic findings, although only half would consider pregnancy termination for anomalies. Reasons for wanting return of abnormal results included preparedness, valuing knowledge, and to a lesser extent, informing decision-making. When considering potential termination as a result of ultrasound findings, participants’ rationales demonstrated deontological (seeing termination as inherently impermissible or permissible), relational (duties arising from the role of being a mother), and consequentialist (weighing harms and benefits) reasoning.
Conclusion
This study highlights women’s perceptions of prenatal ultrasounds as an inherently valuable source of information and preparedness, beyond their role in informing clinical decision-making. Identifying the ethical constructs underpinning patients’ perspectives may help direct development of counseling tools responsive to individual needs and values regarding prenatal ultrasound findings.
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Acknowledgements
The authors wish to thank Dr. Travis Rieder for providing feedback on a previous version of this manuscript.
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This work was supported by the Howard A. Kelly Alumni Society under a 371 grant.
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M.S.G. and A.J. designed the study and helped to collect the data. M.K.H and M.S.G. conducted data analysis. G.G. provide input on the data analysis. M.K.H. drafted the manuscript. M.S.G., G.G., and A.C.J. provided substantive edits on the manuscript.
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Kelly-Hedrick, M., Geller, G., Jelin, A.C. et al. Perceived Value of Prenatal Ultrasound Screening: A Survey of Pregnant Women. Matern Child Health J 27, 101–110 (2023). https://doi.org/10.1007/s10995-022-03515-1
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DOI: https://doi.org/10.1007/s10995-022-03515-1