Doctors Should Test for Down Syndrome

But association of obstetricians and gynecologists says final choice should rest with the mother.

By Randy Dotinga
HealthDay Reporter
Tuesday, May 8, 2007; 12:00 AM

Copyright © 2007 ScoutNews, LLC. All rights reserved.

TUESDAY, May 8 (HealthDay News) -- A leading association of obstetricians and gynecologists is urging pregnant women to take note of its new recommendation that doctors offer to screen them for Down syndrome, no matter how old they are.

But the association is emphasizing that it's not recommending that all pregnant women be screened automatically.

"Not every patient wishes to utilize this type of information," said Dr. Deborah Driscoll, chairwoman of the obstetrics-gynecology department at the University of Pennsylvania. She made her remarks Monday at the American College of Obstetricians and Gynecologists' annual meeting, in San Diego.

"It's important for patients to understand that this is voluntary," added Driscoll, who helped draft the association's recommendations. "Screening isn't right for every patient, and we have to respect the autonomy of patients."

Despite technological advances, it's still anything but simple for pregnant women to determine what do after getting test results that suggest possible problems with a fetus. At issue is the possibility that an unborn child will develop Down syndrome or other conditions related to chromosome abnormalities. Down syndrome can lead to congenital heart defects and mental retardation.

Genetic testing and counseling have traditionally been offered to women aged 35 and over, because they're at highest risk of giving birth to babies with chromosome problems. An estimated one in 92 mothers in this group gives birth to children with chromosomal disorders. But the traditional screening tests -- amniocentesis or chorionic villus sampling -- are both considered invasive and pose a small risk to the fetus.

In January, the American College of Obstetricians and Gynecologists recommended that doctors offer non-invasive screening tests to all mothers before the 20th week of pregnancy. The doctors' group favors a combination of two tests: nuchal translucency (a type of ultrasound exam), and a blood test.

If either of those tests suggests trouble, amniocentesis or chorionic villus sampling may be offered.