Display Settings:

Format

Send to:

Choose Destination
Acta Obstet Gynecol Scand. 2006;85(12):1420-5.

Informed consent: providing information about prenatal examinations.

Author information

  • 1Department of Epidemiology, Institute of Public Health, Research Unit for the General Practice, University of Aarhus, 8000 Aarhus C, Denmark. kd@soci.au.dk

Abstract

BACKGROUND:

Choice in prenatal care has moved on from a paternalistic approach, to increased patient autonomy and informed decision-making. This review summarises the existing literature on the information of pregnant women about prenatal examinations. The extent to which information about Down syndrome and screening tests empowers informed decision-making are investigated, as are different ways of expressing a risk estimate.

RESULTS:

Knowledge scores can be improved and decisional conflict reduced by group counselling, individual sessions, and by use of leaflets. None of the interventions leads to a raise in anxiety scores or influence uptake rates. Satisfaction with information provided was found unrelated to level of knowledge, but associated with having expectations for information met. Information on Down syndrome is missing (13-21%), or restricted (13%), limitations of screenings tests rarely mentioned, and written materials often insufficient. Women experience risk expressed as proportions or relative risk ratio significantly higher than percentage, number needed to treat, or absolute risk reduction. More women correctly understand relative risk reduction compared to absolute risk reduction and number needed to treat (60 versus 42 and 30%). Using medical words rather than lay terms significantly alter risk perception.

CONCLUSIONS:

Information can increase the level of knowledge and reduce decisional conflict, without raising anxiety scores. A clarification of the women's expectations seems paramount to obtain a perception of good information and informed consent. The information provided about Down syndrome and screening tests does not empower an informed consent based on relevant knowledge.

PMID:
17260215
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Blackwell Publishing
    Loading ...
    Write to the Help Desk