From the consulting room: personal narratives of giving prenatal information about fetal anomalies

Two clinical narratives illustrate the dilemmas of prospective parents and their health-care professionals including (expert) sonographers, fetal medicine subspecialists, medical geneticists, and pediatric subspecialists, when confronted with a suspected fetal anomaly that is detected following prenatal testing. On the one hand, the enormous improvement in medical technology has a major impact on the timely detection of fetal anomalies, which allows the expectant couple to make a shared decision about prenatal and/or perinatal management. Management options include tailored perinatal care, noninterventional perinatal management, comfort care, and termination of pregnancy. On the other hand, couples are often ill-prepared for bad news about the health of their unborn child in the case of untoward prenatal or perinatal findings which are not always unequivocal. The detection of a major fetal anomaly also evokes strong emotions. These issues complicate counselling and shared decision-making of women being faced with “unexpected” findings following prenatal screening tests.