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Prenatal screening provides a good illustration of the tensions existing between the intention of control associated with standard risk surveillance and the permanence of uncertainty around life processes. During the screening process, health professionals and pregnant women are not only confronted with the limitations of probabilistic thinking, they are also concretely reminded of the extent of uncertain outcomes. We analysed such tensions, emblematic of the notion of manufactured uncertainty (Giddens 1994), with qualitative data collected in Switzerland from both gynaecologists and mothers-to-be. Doctors experienced difficulties in regards to expectations raised by risk surveillance, the duty to inform and the anxiety surveillance induced. Pregnant women coped in different ways with probabilistic thinking, developing contrasting responses to uncertainty, ranging from scepticism about risk thinking to aspiration for control leading to over use of medical procedures. As uncertainty was central to professional and lay thinking both made use of subjective interpretations and cultural meanings in decisions related to future events

Introduction and AimsMost official healthcare guidelines apply the precautionary principle by recommending that pregnant women abstain from any alcohol consumption. However, a number of women continue drinking alcohol while pregnant. The aim of this study was to investigate couples′ experiences of the issue of alcohol consumption during pregnancy as a transitional process.Design and MethodsThirty semi‐directive joint interviews were conducted with couples expecting their first child in Switzerland. Interviews were analysed thematically with the help of ATLAS.ti.ResultsCouples endorsed the imperative of changing drinking habits and all the women reduced their alcohol consumption, although some reported difficulties. First, we identified three themes describing how couples experienced the woman′s change of drinking habits as a smooth transition: Internalisation of risk discourses, abstinence as a social norm and embodiment of alcohol aversion. Second, we emphasised four kinds of difficulties that couples encountered in their everyday lives: burden of risk discourses, conflicting advice, social occasions and desire for alcohol.Discussion and ConclusionsThis paper makes a significant contribution by examining prenatal drinking change as a transition. In this conceptualisation, the change of alcohol consumption is a relational process that is shaped by multiple changes and social norms. Our findings have important implications for practice. First, health professionals should be aware of the difficulties women experience when they abstain from alcohol during pregnancy. Second, our findings suggest the importance of a patient‐centred approach that considers the role of the partner in supporting a pregnant woman′s change of alcohol consumption.

Purpose: To examine combined first trimester screening (FTS), noninvasive prenatal testing (NIPT) and a two-step policy that combines FTS and NIPT in screening for aneuploidy. Materials and Methods: Retrospective study involving 21?052 pregnancies where FTS was performed at the Praxis Praenatal.de in Duesseldorf, Germany. In each case, the sum risk of trisomy 21, 18 and 13 was computed. We assumed that NIPT detects 99?%, 98?%, 90?% and 99?% of cases with trisomy 21, 18, 13 and sex chromosomal abnormalities and that the false-positive rate is?0.5?%. The following screening policies were examined: NIPT or FTS with sum risk cut-offs of 1 in 50 and 1 in 250 in all patients or a two-step-policy with FTS in all patients followed by NIPT in the intermediate sum risk group.?For the intermediate risk group, sum risk cut-offs of 1 in 50 and 1 in 1000 and 1 in 150 and 1 in 500 were used. Results: There were 127, 34, 13 and 15 pregnancies with trisomy 21, 18, 13 and sex chromosomal abnormalities. 23 fetuses had other chromosomal abnormalities with an increased risk for adverse outcome that are not detectable by NIPT. 20?840 pregnancies were classified as normal as ante- and postnatal examinations did not show any signs of clinically significant chromosomal abnormalities. FTS with a sum risk cut-off of 1 in 50 and 1 in 250 detects 81?% and 91?% for all aneuploidies. NIPT detects 88?% of the respective pregnancies. The 2-step approach with sum risk cut-offs of 1 in 50 and 1 in 1000 detects 94?% of all aneuploidies. With sum risk cut-offs of 1 in 150 and 1 in 500, the detection rate is 93?%. Conclusion: A 2-step policy with FTS for all patients and NIPT in the intermediate risk group results in the highest detection rate of all aneuploidies.