Women’s Expectations and Intention to Terminate Pregnancy in Case of Abnormal Findings at the Second Trimester Level II Ultrasound Scan

Abstract

Objective: The aims of this study were: (1) to explore pregnant women’s background knowledge and expectations of 2nd trimester ultrasound screening, and (2) to investigate women’s intentions to proceed to pregnancy termination if fetal anomaly is detected at the 2nd trimester ultrasound screening. Methods: A prospective, cross-sectional, questionnaire-based study. 300 consecutive pregnant women served as a convenience sample for this study. All the women had had a detailed, 2nd trimester, fetal anomaly scan. The questionnaire was a standardized but not validated, purpose-built structure consisting of five parts: (a) demographics, (b) anamnesis and obstetric history, (c) perceived aim of the scan, (d) expectations from the scan, and (e) intention to terminate pregnancy in case of fetal malformation diagnosis. Statistical analysis was performed with the SPSS 12.0 for Windows. Results: The participants’ mean age was 31.3 (21–45) years. 89.3% of the women filled in the questionnaire. The main reasons for the scan, according to the women, were to exclude fetal abnormalities and to assess the fetal karyotype. The main maternal expectations from the scan were to reduce maternal anxiety and to identify fetal malformations. 75.3% of the women were willing to terminate their pregnancy if fetal abnormalities were detected. Older women more commonly opted for pregnancy termination. Conclusion: The majority of participants have a correct notion about the aim of the ultrasound scan, their expectation is mainly anxiety reduction and a high percentage would proceed to pregnancy termination in the event of the detection of a fetal abnormality.

Maternal coping, appraisals and adjustment following diagnosis of fetal anomaly

“…Advanced maternal age has also been associated with an increased tendency to terminate pregnancies following prenatal diagnosis. 12,13 The reasons for these findings are not clear and warrant further investigation. The current study is limited by a relatively small sample size.…”

“…Results of this study suggest that women's age explained a proportion of the variance in adjustment, with advanced maternal age being associated with increased distress. Advanced maternal age has also been associated with an increased tendency to terminate pregnancies following prenatal diagnosis . The reasons for these findings are not clear and warrant further investigation.…”

“…[6][7][8] Between 58% and 93% of pregnancies are terminated, [9][10][11] particularly in older women. 12,13 Although there is now a body of evidence on the emotional impact of a diagnosis of fetal anomaly, 5 few studies have focused on how women who continue with the pregnancy after such a diagnosis cope. 7,[14][15][16][17][18] The effectiveness of contact with specialist health professionals in discussing the prenatal diagnosis has been found to reduce maternal anxiety.…”

First Trimester Anomaly Scan—The Last Redoubt Won: Open Spina Bifida

“…On the contrary, women who were told their child might have an anomaly, based on ultrasound findings (either false-positive or true-positive cases) are usually intensely anxious the time interval between the screening ultrasound and the conclusive exam, and even beyond it. [78][79][80] The experience itself of waiting for a detailed scan provokes increases in anxiety beyond what pregnant women typically experience. Referral for any highly specialized scan and all specialized prenatal testing are independently associated with increased parental anxiety.…”

Kvinners erfaringer i møtet med abortnemnda ved sene svangerskapsbrudd

“…I en nylig publisert studie som undersøkte kvinners intensjoner med ultralyd, var hovedgrunnen ønske om å avdekke misdannelser og redusere engstelse. 75, 3 % av (N=300) kvinnene svarte at de var villig til å avslutte svangerskapet hvis noe unormalt ble påvist (Athanasiadis et al, 2009). …”