American Journal of Medical Genetics 137A:232 (2005)

Book Review

PRENATAL DIAGNOSIS: THE HUMAN SIDE.By Leonore Abramsky and Jean Chapple.

This is the second edition of a book dealing with issuessurrounding prenatal diagnosis. In the last decades, couplesare being offered an increasing range of information about thehealth of their fetus and the possible reproductive decisions.However, couples are not always aware of the information thatmay be provided by prenatal diagnostic tests.

Themain purpose of the book is to emphasize the importancethat should be given to explaining why prenatal screening isdone before it is performed, how the results should be com-municated and of the need for appropriate follow-up care. Thebook includes 18 chapters frommany contributors coming froma broad range of areas, including medical doctors, nurses,genetic counselors, social workers, lawyers, and parents. Thiswide range of expertise allows for abetter presentation ofmanyof the problems thatmay be encountered in prenatal screeningand ways to avoid them. After a general chapter on the ethicalissues raised by prenatal diagnosis, in the next two chapterspresent the legal issues in Great Britain and USA. Severalchapters then deal with the need for appropriate counselingbefore prenatal diagnosis. While counseling is seen as obliga-tory before invasive tests, such as amniocentesis or CVS,screening tests, such as the triple test or ultrasound examina-tion, are often performed without appropriate counseling.Many pregnant women are referred to these genetic screening

tests without the appropriate information on the possibleresults. This leads to very difficult situations for some of thewomenwhodonotunderstand the reason for the tests. Inmanycases the statistical value of the test is not understood leadingto false conclusions either that the fetus is normal or affected.Several chapters discuss the subject and Iwould like to point inparticular the chapter dealing with counseling before anultrasound examination that may reveal fetal abnormalities.While ultrasound examination is used more and more as ascreening test for malformations, it is seen as a routine test,and most of the women are not coming to the examinationknowing about the possible findings, in particular ‘‘soft signs.’’

The last part of the book is about the communication of theresults and the problems surrounding the termination of thepregnancy including one chapter dealing with frequentpregnancies withmultiple fetuses and the problem of selectivefeticide. Several points of views are discussed including that ofonemother, a father, and a general view of the caring personal.

The book is easy and enjoyable to read. I feel that allprofessionals working with pregnant women should read thisbook in order to be aware of the possible problems surroundingprenatal diagnosis, learn to avoid them, and help the pregnantwoman deal with them better.

Joel ZlotogoraSheba Medical CenterRamat Gan, Israel

DOI 10.1002/ajmg.a.30216

� 2005 Wiley-Liss, Inc.