ON WHAT GROUNDS DO WOMEN PARTICIPATE IN PRENATAL SCREENING

Along with the rapid biomedical development of prenatal screening test s, target groups' attitudes and decisionmaking about, and the acceptan ce of, screening procedures have come into focus. To understand users decision-making, it is essential to understand users' knowledge and pe rceptions of a procedure. The aim of this study was to examine Finnish women's knowledge and perceptions of, and stated reasons to participa te in, two prenatal screening tests: serum screening and mid-trimester ultrasound screening. Subjects (n=1035) for the serum screening surve y were catered for in the maternity care centres of two Finnish towns, where serum screening is available for all pregnant women. After one reminder, 88 per cent returned the questionnaire. Subjects (n=497) for the mid-trimester ultrasound screening survey were catered for in the obstetrical and gynaecological outpatient clinic of the city hospital of another town; the response rate was 85 per cent. Women's perceptio ns of the studied prenatal screening tests, serum screening and mid-tr imester ultrasound screening, differed significantly, even though both are used to detect fetal malformations. Serum screening was far more often perceived to be connected with finding diseases or abnormalities than ultrasound screening. Another interesting finding was that the s tated reasons for screening in general and the subjective reasons for participation were different. Reassurance was the personal reason most often mentioned in both the serum screening and the ultrasound group. Almost all women had the most superficial knowledge about serum scree ning; they knew whether it had been offered and that it is done to scr een for Down syndrome. The greatest gaps in knowledge concerned the se nsitivity of serum screening, its use in screening for congenital neph rosis, and diagnostic tests and their risks. Knowledge was poorer amon g women without a high school education. When counselling women about prenatal screening tests, more emphasis should be given to the sensiti vity of serum screening, all of its screening uses, and the possible d iagnostic tests and their risks. The fact that ultrasound screening ca n detect conditions which may lead to the possibility of a selective a bortion should also be explained more fully. (C) 1998 John Wiley &z So ns, Ltd.