Obtained Consent for antenatal fetal anomaly scan

Abstract

Bhagya Kasun

The objectives of prenatal screening and testing for fetal abnormality include the identification of: Anomalies that are not compatible with life, Anomalies associated with high morbidity and long-term disability, Fetal conditions with the potential for intrauterine therapy, Fetal conditions that will require postnatal investigation or treatment. The study analyzed the current requirement by client and doctors in obtaining the consent, in order to develop a structured protocol to obtain consent. A descriptive cross sectional study using qualitative methods was conducted for the above study. Hundred (n=100) mothers awaiting anomaly scans at the De Soyza maternity hospital, Professorial unit were interviewed by the researchers to obtain their perspectives on consent obtained for the anomaly scan. Twenty (n=20) medical officers of all grades underwent a focus group discussion on their perspectives of obtaining consent for the anomaly scan. Data were analyzed through coding of the transcribed focus group discussions and extraction of main themes. Medical officers of all grades participated in the focus group discussion from intern medical officers to consultant obstetricians. All were in agreement that consent obtaining procedure adopted by the medical officers in the current setting is inadequate. Only verbal consent is obtained usually at the busy clinic set up without allowing the mother adequate time to consider whether she wishes to undergo the anomaly scan. The mother is rarely informed of what the anomaly scan entails and the indication for the procedure. Details on what her options if an anomaly is detected are rarely discussed. Consent is usually not obtained by the doctor who performs the scan and does not involve the partner in the decision making process. The current practice adopted in obtaining consent prior to routine antenatal fetal anomaly scan was inadequate, with little information being provided to the mother and consent not being specifically sought prior to the scan procedure.