[Changes in the methods of practitioners of fetal medicine after the Perruche judgement and the law passed on the 4th of March 2002]. / Modifications des pratiques des acteurs de la médecine foetale après l'arrêt Perruche et la loi du 4 mars 2002.

ABSTRACT

OBJECTIVES: The aim of this study was to evaluate the effect of the "Perruche case" and that of law issued on the 4th of March 2002 in order to moderate the effect of the case on the daily practice of prenatal diagnosis and fetal medicine. MATERIALS AND METHODS: We sent questionnaires to the 186 sonologists of two French regions. Changes in their daily practice, as well as communication with the parents to-be, teaching, and stake in a discussion about the future of their specialty were evaluated. RESULTS: We received 54 answers (29%). Diagnosis and prognosis of fetal anomalies have become more difficult to expose than before for 40% of them. Written information as well as medical reports or explanation about ability and limits of ultrasound have been improved, in content for 64% and in use for 42%. For 45% of practitioners, it has become particularly important to carefully chose words used with patients. Some clinicians stopped or limited second (60%) and third (45%) trimester scans. They expressed their need to learn about legal regulations (50%) or improve communication skills (44%). About 60% felt the Perruche case and the subsequent law help to improve reflection about the future of fetal medicine and prenatal scans. CONCLUSION: While the law was poorly perceived by many physicians, it has enabled a careful reorganization and formalization of fetal medicine and particularly prenatal scans. Further debate is needed on the objectives of fetal sonography. Practitioners themselves should initiate this discussion.