Genetic Counseling for Fetal Abnormalities in a South African Community
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Fetal abnormalities are congenital abnormalities identified prenatally. Women who have a fetal abnormality detected often have to make difficult decisions regarding continuation or termination of the pregnancy. The aims of this research project were: to investigate some of the factors that influenced the decision to terminate a pregnancy in which fetal abnormalities were diagnosed; and to determine the implications for genetic counseling practice in South Africa. The study was retrospective and file-based. A total of 171 women counseled for fetal abnormalities, between 2002 and 2006, were identified and relevant data were collected from their records. Altogether 116/170 (68.2%) women were offered termination of pregnancy, and 73/113 (65%) requested the procedure. Early gestation, gestation at the time termination was offered, and ethnicity of the patient, were significantly associated with a termination request. Black patients were less likely to request termination, but more likely to receive a late diagnosis than other patients. Genetic counselors need to adopt an advocacy and educational role to improve this situation. Furthermore, a better understanding of the cultural and ethnicity-related issues is required.
KeywordsGenetic counseling Fetal abnormalities Termination of pregnancy South Africa
The assistance of Professor Pieter Bekker, of the SA Medical Research Council, with the statistical tests used in this study is much appreciated. The project was undertaken by CT for the research component of the degree of MSc (Med) in Genetic Counseling, at the University of the Witwatersrand, Johannesburg, and the Post-graduate Merit Award of the University is acknowledged. The Mellon Foundation Mentorship Scheme provided funding support for JK.
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