Objectives: It was the main aim of the present retrospective study carried out in Flanders to evaluate how women with a false-positive triple test result look back on their experience and decision making and how many of them make use of the triple test in subsequent pregnancies. Methods: All 508 women tested in the Centre for Human Genetics in Leuven in 1995 who had a positive triple test result followed by a normal amniocentesis outcome were invited to participate in a mailed questionnaire study with open and multiple choice questions in 1998. The response rate was 68%. Results: The answers to the multiple choice question assessing how they look back on their initial expectations regarding the exact meaning of the triple test revealed that less than one half reported that it concerned the identification of ‘a higher risk of carrying a child with Down syndrome (DS)’. Reporting correct initial expectations was significantly associated with a higher education level. The same holds for indecisiveness regarding pregnancy termination should the amniocentesis have detected a fetus with DS. As expected, a large majority of the women reported a high level of distress or worry after the communication of the positive triple test result. Overall the findings show that retrospectively most women had the feeling that the decision to have amniocentesis was their own decision rather than a professional’s. Of the subgroup with one or more subsequent pregnancies 70% had another triple test. Conclusions: The overall results of this study clearly reveal a need for a systematic approach aimed at better informing and counselling pregnant women about the implications and limitations of the triple test. Notwithstanding the reported high level of distress caused by a positive triple test result, a large majority of the women with subsequent pregnancies had another triple test; they represent a clearly higher percentage than in another recent study.

Merkatz IR, Nitowsky HM, Macri JN, Johnson WE: An association between low maternal serum alpha-fetoprotein and fetal chromosomal abnormalities. Am J Obstet Gynecol 1984;148:886–894.
Bogart M, Pandian MR, Jones OW: Abnormal maternal serum chorionic gonadotrophin levels in pregnancies with foetal chromosome abnormalities. Prenat Diagn 1987;7:623–630.
Wald NJ, Cuckle HS, Densem JW, Nanchahal K, Canick JA, Haddow JE, Knight GJ, Palomaki GE: Maternal serum unconjugated oestriol in pregnancies with Down’s syndrome. Br J Obstet Gynaecol 1988;95:334–341.
Ormond KE: Update and review; maternal serum screening. J Genet Couns 1997;6:395–417.
Wald NJ, Kennard A, Hackshaw A, McGuire A: Antenatal screening for Down’s syndrome. J Med Screen 1997;4:181–246.
Clarke AJ: Prenatal genetic screening; in Harper PS, Clarke AJ (eds): Genetics, Society and Clinical Practice. Oxford, Bios, 1997.
Burn J, Fairgrieve S, Franks P, White I, Magnay D: Audit of maternal serum screening: Strategies to augment counselling in response to women’s views. Eur J Hum Genet 1996;4:108–112.
Goel V, Glazier R, Holzapfel S, Pugh P, Summers A: Evaluating patient’s knowledge of maternal serum screening. Prenat Diagn 1996;16:425–430.
Marteau TM: Towards informed decisions about prenatal testing: A review. Prenat Diagn 1995;15:1215–1226.
Salonen R, Kurki L, Lappalainen M: Experiences of mothers participating in maternal serum screening for Down’s syndrome. Eur J Hum Genet 1996;4:113–119.
Glazier R, Goel V, Holzapfel S, Summers A, Pugh P, Yeung M: Written patient information about triple-marker screening: A randomized, controlled trial. Obstet Gynecol 1997;90:769–774.
Green J, Statham H: Psychosocial aspects of prenatal screening and diagnosis; in Marteau TM, Richards M (eds): The Troubled Helix, Cambridge, CUP, 1996.
Santalahti P, Latikka AM, Ryynänen M: Hernminki E: Women’s experience of prenatal screening. Birth 1996;23:101–107.
Decruyenaere M, Evers-Kiebooms G, Van Den Berghe H: Community knowledge of human genetics; in Evers-Kiebooms G, Fryns J-P, Cassiman JJ, Van den Berghe H (eds): Psychosocial Aspects of Genetic Counseling. March of Dimes Birth Defects Foundation. Birth Defects Original Article Series. New York, Wiley, 1992, vol 28, pp 167–184.
Ormond KE, Pergament E, Fine BA: Pre-screening education in multiple marker screening programs: The effect of patient anxiety and knowledge. J Genet Couns 1996;5:69–80.
Goel V, Glazier R, Summers A, Holzapfel S: Psychological outcomes following maternal serum screening: A cohort study. CMAJ 1998;159:651–656.
Marteau TM, Cook R, Kidd J, Michie S, Johnston M, Slack J, Shaw W: The psychological effects of false-positive results in prenatal screening for fetal abnormality: A prospective study. Prenat Diagn 1992;12:205–214.
Rausch DN, Lambert-Messerlian GM, Canick JA: Participation in maternal serum screening following screen positive results in a previous pregnancy. J Med Screen 2000;7:4–6.
Ayme S, Costet N, Seror V: Maternal serum screening in France: Evaluation of a national policy (abstract). 32nd Annual Meeting of the ESHG, Amsterdam, May, 2000.
EUROGAPPP PROJECT 1999–2000 Public and Professional Policy Committee (PPPC) Population genetic screening programmes: Proposed recommendations of the European Society of Human Genetics. Eur J Hum Genet 2000;8:998–1000.
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