Determinants of parental decisions to abort for chromosome abnormalities

Authors

  • Arie Drugan,

    1. Center for Fetal Diagnosis and Therapy, Departments of Obstetrics/Gynecology, Molecular Biology and Genetics, and Center for Molecular Biology, Hutzel Hospital/Wayne State University, Detroit, MI 48201, U.S.A.
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  • Anne Greb,

    1. Center for Fetal Diagnosis and Therapy, Departments of Obstetrics/Gynecology, Molecular Biology and Genetics, and Center for Molecular Biology, Hutzel Hospital/Wayne State University, Detroit, MI 48201, U.S.A.
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  • Mark Paul Johnson,

    1. Center for Fetal Diagnosis and Therapy, Departments of Obstetrics/Gynecology, Molecular Biology and Genetics, and Center for Molecular Biology, Hutzel Hospital/Wayne State University, Detroit, MI 48201, U.S.A.
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  • Eric L. Krivchenia,

    1. Center for Fetal Diagnosis and Therapy, Departments of Obstetrics/Gynecology, Molecular Biology and Genetics, and Center for Molecular Biology, Hutzel Hospital/Wayne State University, Detroit, MI 48201, U.S.A.
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  • Wendy R. Uhlmann,

    1. Center for Fetal Diagnosis and Therapy, Departments of Obstetrics/Gynecology, Molecular Biology and Genetics, and Center for Molecular Biology, Hutzel Hospital/Wayne State University, Detroit, MI 48201, U.S.A.
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  • Kamran S. Moghissi,

    1. Center for Fetal Diagnosis and Therapy, Departments of Obstetrics/Gynecology, Molecular Biology and Genetics, and Center for Molecular Biology, Hutzel Hospital/Wayne State University, Detroit, MI 48201, U.S.A.
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  • Mark I. Evans MD

    Corresponding author
    1. Center for Fetal Diagnosis and Therapy, Departments of Obstetrics/Gynecology, Molecular Biology and Genetics, and Center for Molecular Biology, Hutzel Hospital/Wayne State University, Detroit, MI 48201, U.S.A.
    • Director, Division of Reproductive Genetics, Hutzel Hospital/Wayne State University, 4707 St Antoine Boulevard, Detroit, MI 48201, U.S.A.
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Abstract

Parental decisions concerning the continuation of pregnancy following prenatal detection of abnormal chromosomes were evaluated for 80 patients whose diagnosis and prenatal counselling were performed in our centre. Twenty-two anomalies were diagnosed by chorionic villus sampling (CVS) and 58 by amniocentesis. The severity of the chromosome anomaly and associated ultrasound findings in the first vs. second trimester were correlated with patients' decisions. No difference was found in the likelihood of parental decisions to interrupt or continue a pregnancy between CVS and amniocentesis for either the‘severe’ or the‘questionable’ group of chromosome anomalies. Ninety-three per cent of patients with severe prognosis and 27 per cent with questionable prognosis opted for pregnancy termination (p <0·0001). The association of ultrasound anomalies and termination was highly significant (p< 0·001). The severity of the chromosome anomaly, and, to a lesser extent, the visualization of anomalies on ultrasound were the major determinants of parental decisions to terminate the pregnancy. The diagnosis of an anomaly in the first trimester was no more likely ito lead to a termination of pregnancy than in the second trimester.

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