Encouraging patients to undergo prenatal genetic counseling before the day of amniocentesis. Its effect on the use of amniocentesis.

The purpose of this study was to determine if encouraging in-depth prenatal genetic counseling before the day of possible genetic amniocentesis affected the use of amniocentesis. Five hundred two patients were referred to our center for prenatal genetic services during a 15-month period. All patients were scheduled for genetic counseling before possible amniocentesis. During the initial three months (group I), patients were routinely scheduled for counseling on the same day of the procedure unless they requested earlier counseling. During the subsequent 12 months (group II), patients were encouraged to undergo counseling before the day of planned amniocentesis, and 48% agreed. When early counseling was encouraged, the use of amniocentesis decreased from 85% (group I) to 73% (group II) (P less than .025). Among patients with advanced maternal age as the only indication for testing (n = 375), utilization of amniocentesis decreased from 93% (group I) to 78% (group II) (P less than .005). A policy of encouraging early prenatal genetic counseling appears to be a significant factor in the use of genetic amniocentesis.