Tool helps women decide about invasive prenatal testing: the goal of the program is to help women make informed decisions consistent with their values.(Obstetrics)

SAN FRANCISCO -- A new computerized tool helps pregnant women decide whether they want invasive prenatal testing, Miriam Kuppermann, Ph.D., said during a meeting on antepartum and intrapartum management, sponsored by the University of California, San Francisco.

The tool should be ready for clinical use in 2006, said Dr. Kuppermann of the university.

In a randomized, controlled trial, 496 pregnant women seen at three institutions in the San Francisco Bay area used the computerized decision-assistance tool or viewed a computer version of age-appropriate brochures that the state requires clinicians to give to all pregnant women. Both were available in English and Spanish. Investigators assessed the impact of the tool or the brochures during three follow-up interviews.

"We do emphasize throughout that the goal of our program is neither to get women to test nor to get them not to test. The goal is to help them make an informed decision that is consistent with their own preferences and values," she said.

Immediately after the computer session, 75% of women using the decision-assistance tool correctly estimated their risk for having a baby with Down syndrome, compared with 5% of women in the control group. A significant difference in knowledge persisted in the second follow-up interview 2 weeks later.

The state pamphlets do not provide an individual's risk for Down syndrome, so the difference in knowledge between groups is not too surprising, but it's nevertheless encouraging to see that a high percentage of women understood their risk for trisomy 21 after using the computerized tool, Dr. Kuppermann said.

Immediately after the computer session, about 50% of women in the intervention group correctly estimated their risk for miscarriage related to prenatal testing, compared with 20% of women in the control group.