Document Detail


Family planning decisions after prenatal detection of fetal abnormalities.
MedLine Citation:
PMID:  7977549     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Our purpose was to assess the family planning decisions made by women found to be carrying fetuses with chromosome abnormalities or neural tube defects. STUDY DESIGN: We studied the family planning decisions of 132 women carrying fetuses with chromosome abnormalities (n = 91) or neural tube defects (n = 41) with regard to prenatal diagnosis, pregnancy management decision, patient's gravidity, and maternal and gestational age. RESULTS: Twenty women (17 carrying fetuses with chromosome abnormalities and 3 with fetal neural tube defects) elected permanent sterilization after completion of the affected pregnancy. Only maternal age and fetal chromosome abnormalities were associated with a decision to obtain permanent sterilization. CONCLUSIONS: Most women carrying fetuses with chromosome abnormalities or neural tube defects will not choose permanent sterilization after completion of the pregnancy. Delaying such decisions until resolution of grief and depression is now facilitated by the availability of safe, reliable, and relatively long-term reversible contraceptive agents.
Clinicians examined the family planning decisions of 3938 women who underwent prenatal diagnosis (ultrasonography, amniocentesis, or chorionic villus sampling) at the Division of Reproductive Genetics at the University of Tennessee in Memphis between January 1988 and May 1993. 104 women were carrying fetuses with chromosome abnormalities, of whom 92 opted to terminate their pregnancies. 57 women were carrying fetuses with neural tube defects, of whom 49 chose to end their pregnancies. Among the 91 fetal chromosome abnormality cases with complete information on family planning decisions, 84 had autosomal abnormalities and 7 had sex chromosome abnormalities. Among the 41 fetal neural tube defect cases with complete information on family planning decisions, 22 had spina bifida and 19 had anencephaly. The mean age of women with a chromosome abnormality fetus was higher than that of those with a neural tube defect fetus (36.8 vs. 27.3 years; p 0.03). Just 20 women (15.2%) chose permanent sterilization after continuing or terminating the affected pregnancy. Women carrying fetuses with chromosome abnormalities were more likely to choose permanent sterilization than those carrying fetuses with neural tube defects (18.7% vs. 7.3%; p 0.03). Advanced maternal age was associated with the decision to undergo permanent sterilization (p 0.04). Physicians should counsel women who have opted to terminate a pregnancy of an abnormal fetus to delay any decision to undergo permanent sterilization to allow for resolution of grief and depression. They should advise the women to use safe, reliable, and long term reversible contraceptive agents (e.g., Norplant subdermal implant system, the injectable Depo-Provera, IUDs, and oral contraceptives).
Authors:
L P Shulman; C Grevengood; O P Phillips; S J Gross; P C Mace; S Elias
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  171     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  1994 Nov 
Date Detail:
Created Date:  1994-12-21     Completed Date:  1994-12-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1373-6     Citation Subset:  AIM; IM; J    
Affiliation:
Department of Obstetrics and Gynecology, University of Tennessee, Memphis 38103-2896.
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MeSH Terms
Descriptor/Qualifier:
Adult
Chromosome Aberrations / diagnosis*
Chromosome Disorders
Contraception
Family Planning Services*
Female
Humans
Neural Tube Defects / diagnosis*
Pregnancy
Prenatal Diagnosis*
Sterilization, Reproductive

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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