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Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
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How can we improve amniocentesis decision-making?

Lisa Soleymani Lehmann1

  • 1National Center for Ethics in Health Care, Veterans Health Administration, 810 Vermont Avenue, NW Washington, DC, 20420 USA ; Department of Medicine, Harvard Medical School, Boston, USA ; Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA ; Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, USA.

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Summary
This summary is machine-generated.

Many women undergoing amniocentesis for Down syndrome screening do not use screening test results to inform their decision. Shared decision-making and newer tests like cell-free fetal DNA can improve informed choices.

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Area of Science:

  • Prenatal diagnostics
  • Maternal-fetal medicine
  • Genetics

Background:

  • Amniocentesis offers diagnostic information for fetal aneuploidies but carries miscarriage risks.
  • Prenatal screening tests ideally guide decisions, reducing unnecessary invasive procedures.
  • Current practices show suboptimal integration of screening results into amniocentesis decisions for women of advanced maternal age.

Purpose of the Study:

  • To investigate how women of advanced maternal age make decisions about amniocentesis, particularly regarding the use of prenatal screening test results.
  • To explore potential gaps in counseling and shared decision-making processes between healthcare providers and patients.

Main Methods:

  • Analysis of a survey of 42 Israeli women without medical indications for amniocentesis other than age.
  • Examination of the timing and utilization of noninvasive serum screening tests prior to amniocentesis.

Main Results:

  • One-third of women with prior serum screening did not await results before amniocentesis.
  • 10% of women did not undergo any serum screening before the procedure.
  • Reasons for not integrating screening information remain unclear, possibly due to counseling or patient preferences.

Conclusions:

  • There is a need to enhance shared decision-making to ensure women are fully informed about amniocentesis risks and benefits.
  • Cell-free fetal DNA testing may offer reassurance and reduce the need for invasive procedures.
  • Continued public funding for amniocentesis is supported, emphasizing patient autonomy in decision-making.