Survey of second-trimester maternal serum screening in Japan.

AIM: Second-trimester maternal serum screening (MSS) is the predominant form of prenatal screening in Japan. We hypothesize that patient education and physician knowledge of Down syndrome (DS) screening are insufficient to provide adequate information regarding prenatal screening in Japan. MATERIAL AND METHODS: In-person or telephone interviews with medical personnel were conducted at 25 medical facilities utilizing Afp(4) (Esoterix Genetic Laboratories, LLC, a wholly-owned subsidiary of Laboratory Corporation of America Holdings) second trimester screening. We explored how medical facilities provided information about the MSS process to pregnant women. RESULTS: Before prenatal testing, 60% of medical facilities spent an average of less than 5 min per patient explaining the MSS process. The option of amniocentesis for chromosomal aneuploidy was explained at nearly all facilities, but only 60% explained the risk of amniocentesis. Ultrasound examination for open neural tube defects was explained only at half the facilities. Only five of 25 (20%) medical practitioners explained the possibility of having congenital disorders fetus. CONCLUSION: This study revealed that most obstetricians in Japan do not provide their patients with sufficient information about MSS.

The lived experience of women who undergo prenatal diagnostic testing due to elevated maternal serum alpha-fetoprotein screening.

PURPOSE: To explore the lived experiences of a sample of 16 pregnant women who obtained an elevated maternal serum alpha-fetoprotein screening and had further prenatal diagnostic procedures to determine fetal status. DESIGN: Phenomenology METHODS: Sixteen pregnant women were interviewed on two occasions, immediately after contact with a maternal-fetal medicine specialist, and again during the immediate postpartum period. Interviews were conducted until analysis indicated that there was emergence of common themes. A nine-step method was used in the analysis procedure. RESULTS: The exhaustive description of the experience revealed four chronological reaction periods during the experience. CLINICAL IMPLICATIONS: Interactions clearly demonstrated the need for nursing interventions throughout the experience of prenatal diagnostic testing.

The role of the nurse during amniocentesis.

Amniocentesis is a relatively simple, safe, and accurate diagnostic tool which is being performed with increased frequency in local hospitals. The maternity nurse has a responsibility to know the clinical applications, the role of the nurse during the procedure, and the potential risks associated with amniocentesis.