Harding, E;
Hammond, J;
Chitty, LS;
Hill, M;
Lewis, C;
(2020)
Couples experiences of receiving uncertain results following prenatal microarray or exome sequencing: A mixed-methods systematic review.
Prenatal Diagnosis
, 40
(8)
pp. 1028-1039.
10.1002/pd.5729.
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Abstract
BACKGROUND: Tests in pregnancy such as chromosomal microarray analysis (CMA) and exome sequencing (ES) are increasing diagnostic yield for fetal structural anomalies, but havegreater potential to result in uncertain findings. This systematic review investigated the experiences of prospective parents about receiving uncertain results from these tests. METHODS: A systematic search of three electronic databases was conducted. Data extraction was performed for studies that met the eligibility and quality criteria. Results were synthesised following the principles of thematic analysis. RESULTS: Fourteen studies (ten qualitative, four quantitative) were included. Findings were grouped into three overarching themes. Sources of uncertainty included the testing procedure, the diagnosis and prognosis, and health professionals' own uncertainty. The clinical impact of the uncertainty included parents struggling to make clinical decisions with the information available, the emotional impact included decisional-regret, shock, worry and feeling overwhelmed. To manage the uncertainty, parents sought support from healthcare professionals, friends, family, the internet and other parents as well as remaining hopeful. CONCLUSIONS: Prospective parents experience a myriad of uncertainties in the prenatal setting, which must be handled sensitively. Future research should explore optimal ways of managing uncertainty to minimise harm. Recommendations are made for discussing uncertainty during pre- and post-test counseling. This article is protected by copyright. All rights reserved.
| Type: | Article |
|---|---|
| Title: | Couples experiences of receiving uncertain results following prenatal microarray or exome sequencing: A mixed-methods systematic review |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1002/pd.5729 |
| Publisher version: | http://dx.doi.org/10.1002/pd.5729 |
| Language: | English |
| Additional information: | Copyright © 2020 The Authors. Prenatal Diagnosis published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Genetics and Genomic Medicine Dept UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10096980 |
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