Claire O. Leonard

Genetic Counseling: A Consumers' View

Abstract Parents of families containing children with cystic fibrosis, phenylketonuria, and Downs syndrome were asked questions designed to discover their understanding of the genetic counseling t...

Prenatal screening and pregnant women's attitudes toward the abortion of defective fetuses.

We studied the attitudes of 490 pregnant women toward the abortion of defective fetuses. Three hundred of these women were participating in a prenatal screening program for neural tube defects. Although theoretical accounts of the effects of behavior on attitude would suggest that participation in a screening program would affect abortion attitudes, evidence in support of such an association was weak. The overwhelming majority of women, regardless of whether they had participated in the screening program, believed that women are justified in having an abortion in the face of fetal abnormality. There was a sharp increase in the number of screening program participants who said they would have an abortion when the probability of the fetus being affected with a neural tube defect rose from 95 per cent to 100 per cent.

What participants understand about a maternal serum alpha-fetoprotein screening program

We investigated the knowledge of pregnant women participating in a maternal serum alphafetoprotein (MSAFP) screening program for the detection of neural tube defects (NTDs) in the fetus. Women participating in the screening program scored higher on two knowledge tests than a comparison group of pregnant women who were not offered screening. However, there were substantial gaps in the knowledge base of women in the program, as measured by one of the tests. Women did not misinterpret a negative test result to mean that the test had identified a potential problem with the fetus; instead, there is a suggestion that they tended to interpret a negative result too positively, as an assurance that the baby was healthy in all respects.

Further Studies on the Antenatal Detection of Sickle Cell Anemia and other Hemoglobinopathies

The synthesis of hemoglobin A was measured in small samples of peripheral blood cells from 9- to 20-week human fetuses. In 15 fetuses, synthesis of hemoglobin A accounted for 4 to 13% of total hemoglobin synthesis and the percent of hemoglobin A synthesis varied directly with fetal size. In one aborted fetus of a mother heterozygous for hemoglobins A and S, the synthesis of hemoglobin S was 3.4% and that of hemoglobin A was less than 3% of total hemoglobin synthesis. Peripheral blood cells of normal mothers (AA) synthesize 15–20% as much hemoglobin A as do comparable aliquots of peripheral blood of their fetuses. Therefore, the prenatal diagnosis of sickle cell anemia and other β-chain hemoglobinopathies appears biologically feasible, even with samples of fetal blood in which up to one-third of the cells are of maternal origin. Since amniotic fluid samples do not consistently contain the necessary numbers of fetal blood cells, we believe antenatal diagnosis of hemoglobinopathies awaits development of a safe, reliable, amnioscope to aid in the sampling of small quantities of fetal blood under direct visualization.

Pregnant women's attitudes toward the abortion of defective fetuses

A survey asked 190 pregnant women their opinions on whether a hypothetical other woman would be justified in having an abortion under ten different circumstances, four of which related to abnormalities of the fetus. They were then asked whether they would be justified in having an abortion under these same circumstances. Also assessed were these womens views concerning the justifiability of abortion for a specific group of fetal abnormalities, neural tube defects. Respondents were more likely to view abortion as justifiable for a hypothetical other than for themselves. However, there was no evidence that pregnant womens views about abortion are more conservative than those of the general public. The majority of respondents considered abortion of a defective fetus to be justified, both for themselves and for others. The best predictor of abortion attitudes was respondents views about the ideal number of children in a completed family.