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medpundit |
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Friday, January 30, 2004Most patients have absolutely no clue what is up with the triple screen, and their overworked doctors do not take the time to explain the real utility of this test. Cut away all the talk of risk, percentages and thresholds, and what you have at the end of the day is this- the decision is to abort or not. It is helpful to know about a handicap in advance, but we're kidding ourselves to think that the test was designed to improve prenatal care and planning. With the anxiety of an abnormal test result often hanging over their heads for days to weeks, most of the time due to false-positives, it's hard to say it reduces the anxiety of the patient population overall. Not to mention the incalculable anguish of losing a chromosomally normal child from amniocentesis complications. Once I explain the test in this light- that the triple screen, amniocentesis, and CVS check for conditions about which WE CAN DO NOTHING except offer termination, most of my patients look at me like I'm nuts, and refuse the test. I do encourage AFP-only testing, as it really does help to know about NTD in advance given the improvements in fetal outcomes with prenatal surgery and scheduled C/S. I have an even bigger problem with CF testing [cystic fibrosis - ed.]- a nonfatal disease with which many people live for decades- with their mind and soul quite intact, thank you. While I would never wish the condition on anyone, I certainly wouldn't wish away those who have it. It goes without saying that the Cystic Fibrosis Foundation is mute (literally- I ran a search on their website using "prenatal testing" and found 0 entries) on the topic. I was stunned that ACOG recommended this test be offered to all caucasian couples. What's next? Soon, we'll be able to test for every genetic defect, and patients will be given a checklist of what they want to have tested prenatally. Brave New World, indeed. posted by Sydney on 1/30/2004 07:54:00 AM 0 comments 0 Comments: |
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