Should all pregnant patients be offered prenatal diagnosis regardless of age?

Maurice L. Druzin, Frank Chervenak, Laurence B. McCullough, Robert N. Blatman, Julie A. Neidich

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

Objective: To assess the acceptance of prenatal genetic diagnosis by patients younger than 35 years old who are therefore not yet at great risk for non-disjunction trisomies based on maternal age. Methods: The patients were counseled regarding the following: 1) the age-related risk of chromosomal abnormalities, 2) the procedure-related risk of fetal loss, 3) clinical implications of chromosomal abnormalities, 4) the need for complete counseling by a certified genetic counselor, and 5) the patient expense of $600–1200 if third-party reimbursement was not available. Patients were recruited from the private practice of the senior author at The New York Hospital—Cornell Medical Center. Five hundred ninety-one patients were offered prenatal genetic diagnosis. The outcome measure was the patient’s decision to undergo prenatal diagnosis even though the risk of a non-disjunction trisomy was expected to be low based on maternal age. Amniocentesis was performed in 128 patients and chorionic villus sampling in five. Results: One hundred thirty-three patients (22.5%) chose prenatal diagnosis. Karyotype was obtained in 131 procedures, but two were unsuccessful. One of the 131 karyotypes was abnormal and the patient chose to terminate the pregnancy. Conclusions: The data showed the following: 1) Inappropriate influence of patients by the health provider was not evident; 2) routine offering of genetic diagnosis enhanced the autonomy of pregnant women; 3) the potential increase in the loss of pregnancies that accompanies this practice is ethically justified; and 4) there are no compelling cost-benefit objections to such a practice.

Original languageEnglish
Pages (from-to)615-618
Number of pages4
JournalObstetrics and gynecology
Volume81
Issue number4
StatePublished - Apr 1993
Externally publishedYes

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    Druzin, M. L., Chervenak, F., McCullough, L. B., Blatman, R. N., & Neidich, J. A. (1993). Should all pregnant patients be offered prenatal diagnosis regardless of age? Obstetrics and gynecology, 81(4), 615-618.