PREGNANCY MANAGEMENT DECISIONS BY ADOLESCENTS FOLLOWING 2ND-TRIMESTER PRENATAL-DIAGNOSIS OF FETAL ABNORMALITIES

Study Objective: To evaluate the pregnancy management decisions made by adolescents who were found to be carrying fetuses with abnormalities. Design: Adolescent women who were carrying fetuses with abnormalities detected in the second trimester of pregnancy were evaluated as to their decision to continue or terminate their pregnancies. The decision by these women to include parents, guardians, or partners in the counseling process was also evaluated. Setting: The clinical offices of the Division of Reproductive Genetics, Department of Obstetrics and Gynecology, University of Tennessee, Memphis. Participants: Twelve adolescent women (16 years old or younger) who were found to be carrying fetuses with abnormalities. All participants were between 14 and 20 weeks gestation. Main Outcome Measures: Genetic counseling was provided to five women carrying fetuses with chromosome abnormalities (two trisomy 21, two 45,X, and one trisomy 13), four women with fetuses demonstrating malformations with normal chromosome complements, and three women carrying fetuses with neural tube defects (two spina bifida and one anencephaly). Results: All 12 women elected to have a parent or guardian accompany them for genetic counseling following the detection of fetal abnormalities. In five cases the patient's partner attended the counseling session. All women elected to terminate their pregnancies. Conclusion: Factors other than severity of the abnormality (e.g., desire to terminate the pregnancy irrespective of abnormality, stable and nurturing marital or family relationships, economic independence) may play important roles in the adolescents' decision to continue or terminate a pregnancy after detection of fetal abnormalities.