Tuesday, January 02, 2007
Testing for Down syndrome - Do you want to know?
If you've recently visited the doctor's office, you may have walked out more confused than before you entered. It is true that with the number of detailed tests offered, you may get answers to questions you didn't even know you had. Often times, you are suddenly required to make decisions, big decisions, without a lot of time to think. Nowhere is that more true than when it comes to prenatal screening. And, now new guidelines issued by the American College of Obstetricians and Gynecologists will lead to even more tests, and possibly more questions.
The new recommendation is that all women, regardless of age, be offered screening for Down syndrome. As you may know, Down syndrome is a common birth defect, caused by three copies of the 21 chromosome, instead of the usual two. These children may be mentally delayed in addition to having heart defects. It is well known that older women are more likely to have a child with this defect. For example, a 25-year-old woman has roughly a 1/1,250 chance as compared with a 40-year-old woman, who has a 1/100 chance. The conventional wisdom was that a woman over 35 should be offered an amniocentesis - placement of a needle into the amniotic sac and removal of amniotic fluid for testing. Unfortunately, that test carries a slight risk of miscarriage. Nowadays, non-invasive screening is available that involves testing the woman's blood and performing an ultrasound. In the first trimester of pregnancy, it can tell with more than 90 percent accuracy whether a child has Down syndrome. There is no additional risk of miscarriage, and the costs are fairly reasonable.
The question, though, for many young parents is, "Do we really want to know?" A certain percentage of parents may choose to terminate the pregnancy. Others may choose to immediately establish tax-free health savings accounts to help pay for the health costs of the child. Others may choose to have the child delivered in a hospital that specializes in high risk pregnancies. Many parents are just curious. But, is it worthwhile to know? Do you agree with the new recommendations put forth? Do you think this will reinvigorate the abortion debate?
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