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A 35-Year-Old Pregnant Woman Considering Maternal Serum Screening and Amniocentesis
Michael Mennuti, MD
JAMA. 1996;275(18):1440-1446.
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Dr Daley
: Mrs J, a 35-year-old married attorney and mother of 2 preschool-aged children, is in her first trimester of pregnancy. She is considering maternal serum screening and/or amniocentesis for the detection of neural tube defects and chromosomal abnormalities. She is insured with a managed care organization through her husband's medical insurance.
Mrs J is healthy and has had 3 previous pregnancies. Her first pregnancy was uncomplicated during gestation, with a 40-hour labor, ending in a cesarean delivery of a healthy boy at term. Her second pregnancy ended in a spontaneous miscarriage during the first trimester. In the first trimester of her third pregnancy, Mrs J's obstetrician, Dr O, offered her serum screening and/or amniocentesis. She and her husband declined both, feeling that the risks of neural tube defects and chromosomal abnormalities were low and that they would not be willing to terminate a pregnancy in the second trimester if
. . . [Full Text PDF of this Article]
Footnotes
Dr Mennuti is professor and chairman of the Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia.
This conference took place at the Obstetrics and Gynecology Grand Rounds of the Beth Israel Hospital, Boston, Mass, on January 24, 1996.
Reprint requests to Division of General Medicine and Primary Care, Beth Israel Hospital, 330 Brookline Ave, LY339, Boston, MA 02215 (Ms Walzer).
Clinical Crossroads at Boston's Beth Israel Hospital is produced and edited by Thomas L. Delbanco, MD, and Jennifer Daley, MD; Janet Walzer, MEd, is managing editor. Clinical Crossroads section editor: Margaret A. Winker, MD, Senior Editor, JAMA.
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