Includes bibliographical references. / Following recommendations laid down by a consensus conference in 1986, the policy of the Norwegian government has been to offer a routine ultrasound scan to all pregnant women at 18 weeks of gestation, i.e. in the second trimester (weeks 14-27) of pregnancy . This form of antenatal screening is also provided in other European countries, though several countries have gone further and now offer universal screening in the first trimester (weeks 1-13), between the 11th and 13th week of gestation, as well as in the second. In 2006, the Norwegian Directorate for Health contemplated a revision of its antenatal care guidelines, and in the process, sought to determine whether anexpansion of the programme to incorporate universal first trimester screening would be a rational step with regard to the anticipated extra benefits and costs. Except for a relatively small patient co-payment charge, antenatal screening is publicly financed as is the case with most other healthservices. Norway has however, a small but thriving private healthcare sector, and first trimester ultrasound scanning has been offered by private providers in recent years. The are many potential benefits of antenatal ultrasound screening and some of them are undoubtedly controversial. The information gained from a scan may, depending on its timing, assist in determining the pregnancy term, the number of foetuses in the uterus, the location of the placenta and the condition of the foetus. If the foetus is found to suffer from a particular disease, it may sometimes be treated prior to birth. Invariably however, ultrasound scanning in pregnancy is often associated with the detection of foetal anomalies or defects, such as Down syndrome, congenital heart defects or neural tube defects. The detection can in some cases lead to the pregnancy being terminated, whilst in other cases it may prepare the parents for a life with a child who may requiremore attention and care than others. This provision of information may be considered beneficial, however one may choose to act upon it, although it also invites an active decision which could induce negative feelings. On the other hand, the potential stress and anxiety involved in the screening and diagnostic process may be viewed as disadvantageous. This study will focus on two of the most important anomalies, at least in terms of the attention they are given in the literature: Down syndrome (DS) and serious congenital heart defects (SCHD).
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:uct/oai:localhost:11427/9398 |
| Date | January 2010 |
| Creators | Movik, Espen |
| Contributors | Cleary, Susan |
| Publisher | University of Cape Town, Faculty of Health Sciences, Health Economics Unit |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Master Thesis, Masters, MPH |
| Format | application/pdf |
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