P. Soergel

Background Knowledge and Attitude of Pregnant Women towards Ultrasound Screening at 20-23 Weeks Gestation.

BACKGROUND Prenatal ultrasound screening in the second trimester is widely used in maternal health care. Prenatal diagnosis and prenatal screening is often exposed to several accusation, such as inducing unnecessary anxiety, carrying out a selection and forcing pregnant women into attending ultrasound screening. The aim of this study was to investigate the knowledge and the intention of pregnant women attending the second trimester ultrasound screening. PATIENTS AND METHODS This was a prospective study. Women attending the 20 weeks anomaly scan were given an anonymous questionnaire to evaluate the background knowledge about the anomaly scan and their opinion about prenatal screening. RESULTS 600 (96.7%) of 620 recruited women filled in the questionnaire completely. To the majority (>80%) of women it is important to exclude severe fetal anomalies and to secure normal fetal growth. The background knowledge of the women was good, but a clear supply of information and a detail counselling would improve the understanding, especially in the group of lower education. The majority of the women stated that the 20 weeks anomaly scan should be offered to every woman. CONCLUSION Prenatal ultrasound examination is not only essential from a medical point of view for example for important information regarding the status of the fetus, but also has a major impact as a positive psychological factor for pregnant women.

Risikokommunikation in der Geburtshilfe am Beispiel der elektiven Sectio

ZusammenfassungHintergrundDie Aufklärung vor einer Risikogeburt stellt eine Herausforderung dar, da sie zum einen die zu erwartenden Risiken klar benennen muss, zum anderen jedoch ermutigend sein soll, um der Patientin Ängste zu nehmen und sie motiviert durch die Geburt hindurch begleiten zu können. Mängel in der Aufklärung können trotz medizinisch korrektem Management einen Angriffspunkt für Klagen darstellen, die eine nicht korrigierbare Beweislastumkehr zur Folge haben können.Ziel der Arbeit und FragestellungZiel war es, eine klar verständliche praktische Handlungsvorlage zu geben, um in Risikosituationen Patientinnen adäquat für eine Spontangeburt oder eine Sectio aufklären zu können.Material und MethodenAnalyse der in Deutschland geltenden Gesetzesgrundlagen, der Leitlinien sowie der geltenden Rechtsprechung sowie der für die Sectio häufigsten Indikationen und Risikokonstellationen.ErgebnissePräsentation klarer Vorschläge und Benennung der Eckpunkte von Aufklärungsgesprächen, um diese umfassend und somit wenig angreifbar zu machen.DiskussionEine Risikoaufklärung vor einer Geburt bewegt sich im Spannungsfeld zwischen den Wünschen der Patientin und dem Management, das für die Patientin wie für das Neugeborene die geringsten Risiken birgt.AbstractBackgroundInformed consent is the key to self-determined decision-making of pregnant women. Providing counseling prior to a high-risk birth is a challenge because the relevant medical risks for both vaginal birth and cesarean section must be mentioned, while still being encouraging to allow the patient to remain motivated for birth. Deficits in providing patient information, despite medically correct management, represent a target for medical litigation and may ultimately result in liability.ObjectivesThe goal of this work is to give simple, practical suggestions to enable physicians to communicate competently and sufficiently with patients prior to a high-risk birth or cesarean section, highlight management alternatives, and provide recommendations for documentation.Materials and methodsThe respective German laws, guidelines, and current jurisdiction as well as the common indications and risk constellations potentially resulting in cesarean section were analyzed.ResultsPractical suggestions to enable physicians to make informed consent comprehensive and include all relevant information are provided.ConclusionPatient counseling in high-risk situations is a challenge for physicians to respect both the wishes of the patient and management, while selecting treatment with the lowest possible risk for the mother and neonate.