Open AccessImplementation of combined ultrasound and biochemistry for risk evaluation of chromosomal abnormalities during the first trimester in Sweden
Author(s) -
Ingvoldstad Charlotta,
Georgsson Öhman Susanne,
Lindgren Peter
Publication year - 2014
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.12445
Subject(s) - medicine , amniocentesis , pregnancy , obstetrics , prenatal care , first trimester , second trimester , gynecology , prenatal diagnosis , family medicine , gestation , fetus , environmental health , population , genetics , biology
Objective To investigate how the first trimester risk evaluation for Down syndrome is offered and performed. Setting Sweden. Sample All 52 known units working with obstetric ultrasound. Methods Study‐specific questionnaire and descriptive statistical analyses. Main outcome measures Routines for offering combined ultrasound and biochemistry ( CUB ), questions about information, questions about tests and analysis used for diagnosis. Results CUB was performed in 28 600 (26%) of the expected 110 000 pregnancies in Sweden during 2011. Of all pregnant women, 15% were living in a county not offering CUB (only invasive prenatal diagnosis); 44% regardless of age; 15% to women ≥33 years; 24% to women ≥35 years; and 2% to women ≥38 years old. Amniocentesis was the most common method offered when the risk was estimated as high. Of the 47 units that replied, 29 (61.7%) offered only amniocentesis. On the questions about information, 40 (95.2%) stated that they gave verbal information. In addition to verbal information, 17 (40.5%) gave written information. Forty‐one of the units (71.9%) stated that the CUB is offered to non‐Swedish‐speaking women. Conclusion Without consistent national guidelines, the prenatal diagnostic CUB method is offered in an inequitable manner to pregnant women in Sweden. More than half of all pregnant women live in a county where CUB is not offered or is only offered based on age. The results demonstrate the importance of national consistency before the introduction of new prenatal tests, to enhance equal care for all pregnant women.