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State of the Art Cranial Ultrasound Imaging in Neonates

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Informed decision-making about the fetal anomaly scan: what knowledge is relevant?

H M H J D Schoonen¹, M L Essink-Bot, H M E Van Agt

¹Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. h.schoonen@erasmusmc.nl

Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology

|December 15, 2010

Summary

A new knowledge measure was developed for informed decision-making (IDM) in second-trimester ultrasound screening for fetal anomalies. This tool aids large-scale program evaluations of prenatal screening effectiveness.

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Area of Science:

Prenatal Diagnostics
Medical Decision Making
Health Program Evaluation

Background:

Informed decision-making (IDM) is crucial for prenatal screening.
Understanding knowledge gaps is essential for effective program evaluation.

Purpose of the Study:

To determine essential knowledge for IDM in second-trimester ultrasound screening for fetal anomalies.
To develop a validated knowledge measure for this screening.
To compare knowledge domains with first-trimester Down syndrome screening.

Main Methods:

Literature review to identify screening knowledge domains.
Construction of specific knowledge items for second-trimester ultrasound screening.
Expert consensus (professionals and pregnant women) on decision-relevant knowledge.

Main Results:

All knowledge domains were deemed important for second-trimester ultrasound screening IDM.
Key domains include meaning of abnormal results, disorders screened, screening purpose, and test voluntariness.
High correlation found between knowledge importance for first- and second-trimester screenings, with 'consequences of a positive test' rated higher for first-trimester Down syndrome screening.

Conclusions:

A reliable knowledge measure for second-trimester ultrasound screening for fetal anomalies has been developed.
This measure is suitable for routine, large-scale program evaluations.
Findings support the development of targeted educational interventions for improved IDM.