Changing trends in patient decisions concerning genetic amniocentesis

OBJECTIVE: This study was undertaken to determine whether there was a change in patient decisions concerning genetic amniocentesis during the period 1995-1998. STUDY DESIGN: All patients referred for genetic counseling because of advanced maternal age, abnormal serum triple-screen results, or ultrasonographic abnormalities between January and March 1995 and between January and March 1998 were evaluated through a retrospective chart review. Patient characteristics included age, race, and gestational age. Group 1 consisted of patients from 1995. Group 2 consisted of patients from 1998. Data on patient decisions concerning amniocentesis before and after genetic counseling and ultrasonographic examination were compared in each group. Groups 1 and 2 were then compared with respect to decisions before and after genetic counseling and ultrasonographic evaluation. RESULTS: A total of 112 patients were studied. Group 1 consisted of 53 patients and group 2 consisted of 59 patients. When the groups were compared, no differences in age, race, or gestational age were noted. In group 1, before counseling, 18 of 53 patients desired genetic testing, compared with 44 of 53 after counseling (P = .02). In group 2, before counseling, 4 of 59 patients desired genetic testing, compared with 15 of 59 after counseling (P = .01). A significantly greater number of patients in group 1 than in group 2 desired genetic testing both before counseling (n = 18/53 vs n = 4/59; P = .01) and after counseling (n = 44/53 vs n = 15/59; P = .01). CONCLUSION: Fewer patients at risk for Down syndrome in 1998 than in 1995 desired amniocentesis both before and after genetic counseling and ultrasonographic examination.