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|Title:||Perinatal management of trisomy 18: a survey of obstetricians in Australia, New Zealand and the UK|
de Crespigny, L.
|Citation:||Prenatal Diagnosis, 2014; 34(1):42-49|
|Publisher:||John Wiley & Sons|
|D. J. C. Wilkinson, L. de Crespigny, C. Lees, J. Savulescu, P. Thiele, T. Tran and A. Watkins|
|Abstract:||OBJECTIVE The objective of this study was to explore the attitudes of obstetricians in Australia, New Zealand and the UK towards prenatally diagnosed trisomy 18 (T18). METHOD Obstetricians were contacted by email and invited to participate in an anonymous electronic survey. RESULTS Survey responses were obtained from 1018/3717 (27%) practicing obstetricians/gynaecologists. Most (60%) had managed a case of T18 in the last 2 years. Eighty-five per cent believed that T18 was a ‘lethal malformation’, although 38% expected at least half of liveborn infants to survive for more than 1 week. Twenty-one per cent indicated that a vegetative existence was the best developmental outcome for surviving children. In a case of antenatally diagnosed T18, 95% of obstetricians would provide a mother with the option of termination. If requested, 99% would provide maternal-focused obstetric care (aimed at maternal wellbeing rather than fetal survival), whereas 80% would provide fetal-oriented obstetric care (to maximise fetal survival). Twenty-eight per cent would never discuss the option of caesarean; 21% would always discuss this option. Management options, attitudes and knowledge of T18 were associated with location, practice type, gender and religion of obstetricians. CONCLUSION There is variability in obstetricians' attitudes towards T18, with significant implications for management of affected pregnancies.|
|Keywords:||Chromosomes, Human, Pair 18; Humans; Trisomy; Prenatal Diagnosis; Perinatal Care; Abortion, Induced; Attitude of Health Personnel; Obstetrics; Sex Factors; Pregnancy; Religion; Physicians; Australia; New Zealand; Female; Male; Congenital Abnormalities; Surveys and Questionnaires; Practice Patterns, Physicians'; United Kingdom; Trisomy 18 Syndrome|
|Rights:||© 2013 The Authors. Prenatal Diagnosis published by John Wiley & Sons, Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.|
|Appears in Collections:||Obstetrics and Gynaecology publications|
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