Diagnosis of Fetal Malformation in the 32nd Week of Gestation. A Psychological Challenge to the Woman and the Doctor

During a 3 year period, 15 cases of fetal malformation were diagnosed by routine ultrasound scanning in the 32nd week of gestation and 14 women were interviewed in order to find out how this diagnosis influenced the remainder of the pregnancy, the delivery and their future reproductive life.

Abstract

During a 3 year period, 15 cases of fetal malformation were diagnosed by routine ultrasound scanning in the 32nd week of gestation. Fourteen women were interviewed in order to find out how this diagnosis influenced the remainder of the pregnancy, the delivery and their future reproductive life. In one case intrauterine fetal death occurred in gestational week 36; this woman was excluded from the study. The women were divided into 2 groups according to the type of malformation of the fetus. In one group, the children would probably be permanently affected; in the other the children could, after adequate treatment, be expected to be healthy. All the women were emotionally unbalanced during the remainder of the pregnancy and had great difficulty in forming a realistic picture of their child. At the time of the interview, all the women had adapted to their situation. Eleven women were told about the fetal malformation immediately after the ultrasound examination, whereas three were not informed prior to delivery. All 14 women considered it very important to be informed as soon as the malformation had been diagnosed; any postponement was found to be unacceptable. Discovering a fetal malformation late in pregnancy commits the woman to the fact that she has to give birth to a malformed child. The situation requires the obstetrician to be prepared to support the parents by offering repeated contact and opportunities to discuss the problem.