Abstract
This study investigated parental decision-making to terminate or continue a pregnancy after prenatal diagnosis of a chromosomal abnormality among a sample of patients in Southeast Turkey. Between 2004 and 2007, 1068 amniocentesis tests were performed in the Medical Biology and Genetic Department Laboratory at Dicle University. Aneuploidy was found in 38 cases (3.56%). Genetic counseling was provided for the couples that received abnormal results, and they were later interviewed and asked if they had continued or interrupted the pregnancy after the diagnosis. When confronted with autosomal aneuploidy in which a severe prognosis was expected, 85% of cases decided to terminate the pregnancy. When confronted with sex chromosome aneuploidy with a low risk of an abnormal clinical phenotype 60% of cases decided to continue the pregnancy. Among the diagnoses with aneuploidy, pregnancy was continued in 21.1% of cases due to religious beliefs regardless of whether there was a low or severe risk of an abnormal clinical phenotype. These findings indicate that both severity of abnormality and religiosity play an important role in genetic counseling patients’ decision-making processes and outcomes in Turkey. In addition, the findings suggest the need for legislation that reduces the differences in approaches between the physicians and institutions regarding parental decision-making to terminate or continue a pregnancy in our country.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Akdeniz, N., Kale, A., Erdemoglu, M., Yalinkaya, A., & Yayla, M. (2005). Retrospective analysis of the 126 cases terminated in pregnancy by the ethical committee decision. Perinatal Journal, 13(2), 80–85.
Awwad, R., Veach, P. M., Bartels, D. M., & LeRoy, B. S. (2008). Culture and acculturation influences on Palestinian perceptions of prenatal genetic counseling. Journal of Genetic Counseling, 17(1), 101–116. Epub 2007 Oct 26.
Brun, J., Gangbo, F., Wen, Z. Q., et al. (2004). Prenatal diagnosis and management of sex chromosome aneuploidy: a report on 98 cases. Prenatal Diagnosis, 24, 213–218.
Drugan, A., Greb, A., Johnson, M. P., Krivchenia, E. L., Uhlmann, W. R., Moghissi, K. S., et al. (1990). Determinants of parental decisions to abort for chromosome abnormalities. Prenatal Diagnosis, 10, 483–490.
Eldahdah, L. T., Ormond, K. E., Nassar, A. H., Khalil, T., & Zahed, L. F. (2007). Outcome of chromosomally abnormal pregnancies in Lebanon: obstetricians’ roles during and after prenatal diagnosis. Prenatal Diagnosis, 27, 525–534.
Evans, M. I., Sobiecki, M. A., Krivchenia, E. L., et al. (1996). Parental decisions to terminate/continue following abnormal cytogenetic prenatal diagnosis: “What is still more important than when”. American Journal of Medical Genetics Part A, 61, 353–355.
Forrester, M. B., & Merz, R. D. (2003). Pregnancy outcomes and prenatal diagnosis of sex chromosome abnormalities in Hawaii, 1986–1999. American Journal of Medical Genetics Part A, 119, 305–310.
Fransen, M. P., Essink-Bot, M. L., Oenema, A., Mackenbach, J. P., Steegers, E. A., & Wildschut, H. I. (2007). Ethnic differences in determinants of participation and non-participation in prenatal screening for Down syndrome: a theoretical framework. Prenatal Diagnosis, 27(10), 938–950.
Graham, R. H., Mason, K., Rankin, J., & Robson, S. C. (2009). The role of feticide in the context of late termination of pregnancy: a qualitative study of health professionals’ and parents’ views. Prenatal Diagnosis, 29, 875–881.
Holmes-Siedle, M., Ryynanen, M., & Lindenbaum, R. H. (1987). Parental decisions regarding termination of pregnancy following prenatal detection of sec chromosome abnormality. Prenatal Diagnosis, 7, 239–244.
Lewando-Hundt, G., Shoham-Vardi, I., Beckerleg, S., Belmaker, I., Kassem, F., & Jaafar, A. A. (2001). Knowledge, action and resistance: the selective use of pre-natal screening among Bedouin women of the Negev. Israel Medical Association Journal, 52(4), 561–569.
Mansfield, C., Hopfer, S., & Marteau, T. M. (1999). Termination rates after prenatal diagnosis of Down syndrome, Spina Bifida, Anencephaly, and Turner and Klinefelter syndromes: a systematic literature review. Prenatal Diagnosis, 19, 808–812.
Mezei, G., Papp, C., Toth-Pal, E., Beke, A., & Papp, Z. (2004). Factors influencing parental decision making in prenatal diagnosis of sex chromosome aneuploidy. Obstetrics and Gynecology, 104, 94–101.
Petrucelli, N., Walker, M., & Schorry, E. (1998). Continuation of pregnancy following the diagnosis of a fetal sex chromosome abnormality: a study of parents’ counseling needs and experiences. Journal of Genetic Counseling, 7(5), 401–415.
Press, N., & Browner, C. H. (1997). Why women say yes to prenatal diagnosis. Social Science & Medicine, 45(7), 979–989.
Quadrelli, R., Quadrelli, A., Mechoso, B., Laufer, M., Jaumandreu, C., & Vaglio, A. (2007). Parental decisions to abort or continue a pregnancy following prenatal diagnosis of chromosomal abnormalities in a setting where termination of pregnancy is not legally available. Prenatal Diagnosis, 27, 228–232.
Shaffer, B. L., Caughey, A. B., & Norton, M. E. (2006). Variation in the decision to terminate pregnancy in the setting of fetal aneuploidy. Prenatal Diagnosis, 26, 667–671.
Verp, M. S., Bombard, A. T., Simpson, J. L., & Elias, S. (1988). Parental decision following prenatal diagnosis of fetal chromosome anomalies. American Journal of Medical Genetics, 29, 613–622.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Balkan, M., Kalkanli, S., Akbas, H. et al. Parental Decisions Regarding a Prenatally Detected Fetal Chromosomal Abnormality and the Impact of Genetic Counseling: An Analysis of 38 Cases with Aneuploidy in Southeast Turkey. J Genet Counsel 19, 241–246 (2010). https://doi.org/10.1007/s10897-009-9275-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10897-009-9275-3