Ultrasound screening for chromosomal abnormality: Women's reactions to false positive results

Objective. Ultrasound scans have become a routine part of antenatal cart. R ecent developments have meant that ultrasound has gone beyond monitoring th e pregnancy and diagnosis of major abnormalities. Its routine use now inclu des screening for subtle fetal abnormalities and indications of chromosomal abnormality. Unfortunately ultrasound screening For chromosomal abnormalit ies has a low positive predictive value (similar to maternal serum screenin g), and only about 2% of pregnancies identified as 'high risk' will be diag nosed with a chromosomal abnormality. The other 98% of 'high risk' results are termed 'false positive'. The aim of this paper is to elucidate the rang e of subjective experiences of women in response to having these results. Method. The approach employed was interpretative phenomenological analysis. Semi-structured interviews were carried out with 24 pregnant women after ` false positive' ultrasound results. These were subjected to a qualitative a nalysis. Results. Participants perceived the ultrasound scan primarily as a social, non-medical event and were unprepared for the result the scan elicited. Two -thirds described residual feelings of anxiety even alter normal diagnostic results were known, sometimes attributed tu continued fears about fetal ab normality, but more often attributed to a generalized feeling that somethin g else unexpected could happen to threaten the pregnancy. Conclusions. The paper has pointed to important discrepancies in the experi ences of women undergoing ultrasound screening and the aims of informed cho ice. We would suggest consideration should be given to providing informatio n on both the medical purposes of screening and on possible outcomes from i t. The study also points to the possible need for counselling support for t he majority of women who so on to receive confirmation of a negative diagno sis, counselling addressed at helping women to readjust to having a 'low ri sk' pregnancy.