Johnson, Judith, Arezina, Jane, Tomlin, Liz, Alt, Siobhan, Arnold, Jon, Bailey, Sarah, Beety, Hannah, Bender-Atik, Ruth, Bryant, Louise, Coates, Jen, Collinge, Sam, Fishburn, Jo, Fisher, Jane, Fowler, Jan, Glanville, Tracey, Hallett, Julian, Harley-Roberts, Ailith, Harrison, Gill, Horwood, Karen, Hynes, Catriona, Kimm, Lindsay, McGuinness, Alison, Potter, Lucy, Powell, Liane, Ramsay, Janelle, Shakes, Pieta, Sicklen, Roxanne, Sims, Alexander, Stacey, Tomasina, Sumra, Anushka, Thomas, Samantha, Todd, Karen, Torrington, Jacquie, Trueman, Rebecca, Walsh, Lorraine, Watkins, Katherine, Yaz, Gill, and Hardicre, Natasha K. (2020) UK consensus guidelines for the delivery of unexpected news in obstetric ultrasound: The ASCKS framework. Ultrasound, 28 (4). pp. 235-245.

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Abstract

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.

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