An essential guide to this major contemporary issue, Consanguinity in Context is a uniquely comprehensive account of intra-familial marriage. Detailed information on past and present religious, social, and legal practices and prohibitions is presented as a backdrop to the preferences and beliefs of the 1100+ million people in consanguineous unions. Chapters on population genetics, and the role of consanguinity in reproductive behaviour and genetic variation, set the scene for critical analyses of the influence of consanguinity in the early years of life. The discussion on consanguinity and disorders of adulthood is the first review of its kind and is particularly relevant given the ageing of the global population. Incest is treated as a separate issue, with historical and present-day examples examined. The final three chapters deal in detail with practical issues, including genetic testing, education and counselling, national and international legislation and imperatives, and the future of consanguineous marriage worldwide.

Consanguinity in Context: Contents

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Consanguinity in Context

BACKGROUND: The present trend towards selective single embryo transfer (SET) calls for evaluation of patient attitudes towards twins and how the patients balance advantages and disadvantages of one or two embryos in IVF/ICSI treatment. METHODS: The study was conducted in a Danish public fertility clinic, where the common practice was double embryo transfer (DET), and the number of reimbursed treatments was limited to three. Referred patients were given oral and written information about the IVF/ICSI treatment including twin probability following DET and the risk of preterm delivery and neonatal complications associated with twins. In order to evaluate patients and partners attitudes towards twins and SET, an anonymous survey was conducted, and 588 couples were invited to participate. RESULTS: Four hundred and fourteen women (70.4%) and 404 men (68.7%) answered the questionnaire adequately for analysis. About 58.7% preferred having twins to having one child at a time (37.9%). Primary reasons for preferring twins were desire for siblings (23.3%), a positive attitude towards twins (22.5%), and a wish to minimize physical and psychological stress through having as few IVF treatments as possible (19.3%). Economic considerations were not important. CONCLUSIONS: Obligatory single embryo policy would be in conflict with patient interests and wishes. More carefully prepared information seems to be needed. The challenge consists in balancing clinical considerations with unbiased information on twin pregnancy, respecting patient autonomy and enabling informed decision-making.

Patient attitudes towards twin pregnancies and single embryo transfer—a questionnaire study

'I want a choice, but I don't want to decide'--a qualitative study of pregnant women's experiences regarding early ultrasound risk assessment for chromosomal anomalies.

Did I really want to know this? Pregnant women's reaction to detection of a soft marker during ultrasound screening.

Background. Choice in prenatal care has moved on from a paternalistic approach, to increased patient autonomy and informed decision-making. This review summarises the existing literature on the information of pregnant women about prenatal examinations. The extent to which information about Down syndrome and screening tests empowers informed decision-making are investigated, as are different ways of expressing a risk estimate. Results. Knowledge scores can be improved and decisional conflict reduced by group counselling, individual sessions, and by use of leaflets. None of the interventions leads to a raise in anxiety scores or influence uptake rates. Satisfaction with information provided was found unrelated to level of knowledge, but associated with having expectations for information met. Information on Down syndrome is missing (13–21%), or restricted (13%), limitations of screenings tests rarely mentioned, and written materials often insufficient. Women experience risk expressed as proportions or relat...

Informed consent: providing information about prenatal examinations

Background. Providing women with information enabling an informed consent to prenatal examinations has been widely recommended. Objective. The primary purpose of this review is to summarise the current knowledge of the pregnant woman's expectations and attitudes concerning prenatal examinations, as well as the knowledge possessed by pregnant women undergoing prenatal examinations. Second, we explore their reasons for accepting or declining available screening tests. Results. More than 90% of the pregnant women expressed a positive attitude toward screening procedures in pregnancy. Most often (70–96%), the pregnant women were found knowledgeable about the procedural and practical aspects, but were more seldom (31–81%) able to correctly identify the purpose of tracing fetal malformations. Some 29–65% were not familiar with the existence of a false negative result, and 30–43% were found unaware of the possibility of a false positive result. The risk of miscarriage in relation to amniocentetesis [AC] is unkno...

https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1080/00016340600985164

Informed consent: attitudes, knowledge and information concerning prenatal examinations

INTRODUCTION In 2004, The Danish National Board of Health introduced new guidelines for prenatal screening and diagnosis. Subsequently, all pregnant women in Denmark have been offered a maternal serum screening and a nuchal translucency measurement (NTM). The results are combined to a single risk estimate of carrying a Down syndrome child. All pregnant women are also offered a late second trimester scan for fetal abnormalities. Pregnant woman should be fully informed to enable them to make an informed choice. We explored the role of information in the pregnant women's understanding and decision-making for the NTM. MATERIALS AND METHODS 26 consenting pregnant women were interviewed after their first visit to their GP and again after the late ultrasound scan. Our results are mainly based on the first interviews and the 24 participants who chose to have a NTM. RESULTS The pregnant women consider a fetal scan as an attractive routine procedure during pregnancy. Apart from the information about prenatal examinations given by the GP, the pregnant women do not subsequently seek further information. The most important motives for wanting to have the NTM are 1) assurance, 2) choice, 3) expectations of the scan being a happy event, and 4) the idea that the examinations are approved by the Danish health care system. DISCUSSION The decision to have a NTM is motivated by expectations that exceed the specific medical aim of the examination and the content of the information provided. The pregnant women believe in a link between knowledge and anxiety, and therefore do not wish to "know too much". Our results show that the pregnant woman's conception of the information provided and her motives for having a NTM are based on strategies and rationales that hinder an informed choice.

[A qualitative study of pregnant women's choice of nuchal translucency measurement].

The SENTIREC-endo study - Risks and benefits of a national adoption of sentinel node mapping in low and intermediate risk endometrial cancer.

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Informed consent: providing information about prenatal examinations

Informed consent: attitudes, knowledge and information concerning prenatal examinations

[A qualitative study of pregnant women's choice of nuchal translucency measurement].

The SENTIREC-endo study - Risks and benefits of a national adoption of sentinel node mapping in low and intermediate risk endometrial cancer.