Comment le risque devient une évidence : praticiens, femmes enceintes et dépistage prénatal de la trisomie 21

Abstract

In France as in other industrialized countries, pregnancy is regarded as a risk period. As such, a medical surveillance on a regular basis is necessary. Among all the risks that are anticipated, specific public policies have been implemented to control the risk of fetal anomaly. This paper focusses on Down’s syndrome (DS) screening programmes, in order to analyze which representations of the risk of DS are produced in consultations. How is the screening test presented to pregnant women, and accepted or declined? We observed two types of consultations: first trimester fetal ultrasound scan when the nuchal translucency measurement may indicate a risk of fetal DS, and first pregnancy consultation when doctors or midwives propose the maternal serum markers test. Although the regulatory frames of these activities and the sociotechnical settings are different, the observed practices are quite similar. Various regulations, as well as time constraints and emotional pressures, contribute to construct the importance of the DS risk and the use of screening tests as self-evident.

Keywords

• risk
• Down’s syndrome
• screening
• consent
• France
• ultrasound