Patient preferences for screening in the first trimester

Objective We theorized that a significant number of women would choose integrated screening (IS) over first trimester screening (FTS) and that demographic characteristics and baseline anxiety levels might predict which patients would choose each test. We also hypothesized that screening results might alter patients' future preferences. Method Patients underwent non-directive genetic counselling and were offered FTS or IS. Prior to undergoing nuchal translucency (NT) ultrasound, patients were given surveys. These questionnaires were repeated in the second trimester and postpartum. They focussed on the patients' background, motivations for screening and anxiety level. Results Out of 110 patients surveyed, 81 returned their initial questionnaire. 60% of these patients chose FTS and 40% chose IS. There were no demographic differences between the groups. FTS patients desired early reassurance while IS patients wanted the 'most information' and the lowest chance of needing diagnostic testing. In all, 47 women returned second trimester questionnaires and 35 women returned postpartum surveys. These surveys demonstrated that women's motivations remained constant over time. Of the five screen positive results, only one woman regretted her screening choice. Conclusion One cannot predict patients' screening preferences, thus both FTS and IS should be offered. Given non-directive counselling, patients are generally satisfied with their screening choices.