Story of the Month - April 2018

Story of the Month - April 2018 

每月故事 - 二零一八年四月

 

Centre member Dr Janice Ying-chui Lau completed her MPhil in Anthropology in CUHK, and her interest in medical anthropology led her further to acquire a PhD in Public Health at CUHK. Dr Lau, with her supervisors Prof Huso Yi and Prof Martin Wong, spearheaded a project on bioethical and social issues revolving decision-making by pregnant women over the choice of NIPT (Non-invasive Prenatal Test) Vs IPD (Invasive Prenatal Diagnosis) regarding the detection of Down Syndrome.

本中心成員劉影翠博士在香港中文大學完成了人類學碩士學位後,由於對醫學人類學的興趣,她進而在中大取得了公共衛生哲學博士學位。在李湖樹教授和黃至生教授的共同指導下,劉博士進行了一項關於孕婦在選擇使用NIPT(無創性唐氏綜合症產前診斷)與IPD(侵入性產前診斷)去測試有關唐氏綜合症的決策時,可能引伸的生物倫理和社會問題的研究項目。

 

NIPT is a ground-breaking clinical technique developed by Prof Dennis Lo. It utilises DNA sequencing technologies to detect Down syndrome in fetuses by directly analysing a blood sample from the mother. In her study, Dr Lau conducted in-depth interviews with 60 Hong Kong Chinese pregnant women (45 NIPT and 15 IPD users). Her qualitative findings revealed that the majority of women who chose NIPT were from the higher income group. They were at high maternal age, who were disturbed by pregnancy-related issues such as infertility, miscarriage symptom, or had a miscarriage history, and wanted to avoid risks associated with Invasive Prenatal Diagnosis.

NIPT是盧煜明教授研發的一項開創性臨床技術。此測試採用DNA測序技術,直接從母親的血液樣本進行分析。在她的研究中,劉博士與60位香港華人孕婦(45NIPT15IPD使用者)進行了深入訪談。定性研究結果顯示,大多數選擇NIPT的女性來自高收入群體。們處於高齡,受懷孕相關問題困擾,如不育症,有流產症狀,或有流產史,並希望避免使用侵入性產前診斷引致的相關的風險。

 

The findings show that most participants valued aspects of both relational and individual autonomy in decision-making for NIPT. Women expected support from doctors as experts on the topic and wanted to involve their husband in decision-making while retaining control over the outcome. Somewhat surprisingly, the findings do not provide support for the involvement of family members in decision-making for NIPT. 

結果顯示大多數參加者在NIPT的決策過程中都重視關係自主和個人自主。 她們期望醫生能以專家的身份跟她們討論這個話題,並希望她們的丈夫在決策過程中參與,而同時保留她們對決策的控制有點令人驚訝的是,結果並不支持孕婦的家庭的成員參與NIPT決策的論據

 

The study recommends that information with regards to NIPT need to be regularly updated and made more easily available to women so that they could make timely, informed choices. It is thus essential to provide adequate information through pamphlets in O&G clinics in public hospitals, and to train health professionals in NIPT to support pregnant women in Hong Kong. 

該研究亦建議,有關NIPT的信息需要定期更新,以便婦女更容易獲得,並能够做出及時的、知情的選擇。因此,透過在公立醫院的婦產科專科診所派發小册子以提供充足的資訊,並為提供NIPT的醫護人員進行培訓,以支持香港的孕婦在作出醫療決策過程都是重要的。

 

 

 

 Storyofthemonth Apr2018

Pregnant women experience the joy of pregnancy while feeling burdened by the need of testing fetal disability (Photo credit: Ms Elaine Ng)
孕婦體驗到懷孕的喜悅,但同時由於需要胎兒檢測是否有先天殘疾而感到負擔 (圖片由Elaine Ng小姐提供)

 

 

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