UK consensus guidelines for the delivery of unexpected news in obstetric ultrasound: The ASCKS framework

Background: Studies indicate there is a need to improve the delivery of unexpected news via obstetric ultrasound, but there have been few advances in this area. One factor preventing improvement has been a lack of consensus regarding the appropriate phrases and behaviours which sonographers and ultrasound practitioners should use in these situations. Aims: To develop consensus guidelines for unexpected news delivery in Early Pregnancy Unit and Fetal Anomaly Screening Programme NHS settings. Methods: A workshop was conducted to identify priorities and reach consensus on areas of contention. Contributors included interdisciplinary healthcare professionals, policy experts, representatives from third-sector organisations, lay experts and academic researchers (n = 28). Written and verbal feedback was used to draft initial guidance which was then circulated amongst the wider writing group (n = 39). Revisions were undertaken until consensus was reached. Results: Consensus guidelines were developed outlining the behaviours and phrases which should be used during scans where unexpected findings are identified. Specific recommendations included that: honest and clear communication should be prioritised, even with uncertain findings; technical terms should be used, but these should be written down together with their lay interpretations; unless expectant parents use other terminology (e.g. ‘foetus’), the term ‘baby’ should be used as a default, even in early pregnancy; at the initial news disclosure, communication should focus on information provision. Expectant parents should not be asked to make decisions during the scan. Conclusions: These recommendations can be used to develop and improve news delivery interventions in obstetric ultrasound settings. The full guidelines can be accessed online as supplemental material and at https://doi.org/10.5518/100/24

UK consensus guidelines for the delivery of unexpected news in obstetric ultrasound: the ASCKS framework

Background: studies indicatethere is a need to improve the delivery of unexpected news via obstetric ultrasound, but there have been few advances in this area. One factor preventing improvement has been a lack of consensus regarding the appropriate phrases and behaviours which sonographers and ultrasound practitioners should use in these situations.Aims: to develop consensus guidelines forunexpected news delivery inEarly Pregnancy Unit (EPU) and Fetal Anomaly Screening Programme (FASP) NHS settings.Methods: a workshop was conducted to identify priorities and reach consensus on areas of contention.Contributors included interdisciplinary healthcare professionals, policy experts, representatives from third-sector organisations, lay experts and academic researchers (n = 28). Written and verbal feedback was used to draft initial guidance which wasthen circulated amongstthe wider writing group (n = 39). Revisionswereundertaken untilconsensus was reached.Results: consensus guidelines were developed outliningthe behaviours and phrases which should be used during scans where unexpected findings areidentified. Specific recommendations included that: honest andclear communication should be prioritised, evenwith uncertain findings; technical terms should be used, but these should be written down together with their lay interpretations; unless expectant parents use other terminology (e.g., ‘fetus’), the term ‘baby’ should be used as a default, even in early pregnancy; atthe initial news disclosure, communication should focus oninformationprovision. Expectant parents should not be asked to make decisions during the scan.Conclusions: these recommendations can be used to develop and improve news delivery interventions inobstetric ultrasound settings