Perinatal management of trisomy 18: a survey of obstetricians in Australia, New Zealand and the UK. (30th October 2013)

• Record Type: Journal Article
• Authors: Wilkinson, D. J. C.; de, L.; Lees, C.; Savulescu, J.; Thiele, P.; Tran, T.; Watkins, A.
• Is Part Of: Prenatal diagnosis. Volume 34:Number 1(2014:Jan.)
• Page Start: 42
• Page End: 49
• Publication Date: 2013-10-30
• Subjects: Prenatal diagnosis -- Periodicals; Fetus -- Diseases -- Diagnosis -- Periodicals; Electronic journals; 618.32075
• DOI: 10.1002/pd.4249
• Languages: English
• ISSNs: 0197-3851

Abstract

<abstract abstract-type="main"> <title>ABSTRACT</title> <sec id="pd4249-sec-0001" sec-type="section"> <title>Objective</title> <p>The objective of this study was to explore the attitudes of obstetricians in Australia, New Zealand and the UK towards prenatally diagnosed trisomy 18 (T18).</p> </sec> <sec id="pd4249-sec-0002" sec-type="section"> <title>Method</title> <p>Obstetricians were contacted by email and invited to participate in an anonymous electronic survey.</p> </sec> <sec id="pd4249-sec-0003" sec-type="section"> <title>Results</title> <p>Survey responses were obtained from 1018/3717 (27%) practicing obstetricians/gynaecologists. Most (60%) had managed a case of T18 in the last 2 years. Eighty‐five per cent believed that T18 was a 'lethal malformation', although 38% expected at least half of liveborn infants to survive for more than 1 week. Twenty‐one per cent indicated that a vegetative existence was the best developmental outcome for surviving children. In a case of antenatally diagnosed T18, 95% of obstetricians would provide a mother with the option of termination. If requested, 99% would provide maternal‐focused obstetric care (aimed at maternal wellbeing rather than fetal survival), whereas 80% would provide fetal‐oriented obstetric care (to maximise fetal survival). Twenty‐eight per cent would never discuss the option of caesarean; 21% would always discuss this option. Management options, attitudes and knowledge of T18 were associated with location, practice type, gender and religion of obstetricians.</p> </sec> <sec id="pd4249-sec-0004" sec-type="section"> <title>Conclusion</title> <p>There is variability in obstetricians' attitudes towards T18, with significant implications for management of affected pregnancies. © 2013 The Authors. <italic>Prenatal Diagnosis</italic> published by John Wiley & Sons, Ltd.</p> </sec> </abstract>