The asymmetries of first-trimester combined screening of pregnancy in Portugal
DOI:
https://doi.org/10.32385/rpmgf.v41i3.13144Keywords:
First-trimester combined screening, Health equity, Health services accessibility, Healthcare disparitiesAbstract
The first-trimester combined pregnancy screening aims to assess the embryo’s risk of chromosomal abnormalities, namely trisomy 13, 18, and 21. It results from a combination of maternal age and data obtained from the 1st trimester ultrasound and blood tests. Several international and national entities advise that the first-trimester combined screening should be carried out for all pregnant women, regardless of age. However, asymmetries in healthcare access may compromise equity among pregnant women. The lack of trained human resources in some regions of Portugal was recognized in the 2011 prenatal diagnosis report by Direção-Geral da Saúde. This report also points out logistical issues, such as a lack of high-definition ultrasound scanning equipment and physical space. Currently, a structured first-trimester combined screening is not provided by primary care, but only by hospital obstetrics services, and is not available in all hospitals. It is crucial that equity in health is established and that pregnant women have access to first-trimester combined screening in an accredited and high-quality service, regardless of where they live. It is therefore urgent to invest in maternal healthcare to end inequity in access to first-trimester combined screening in the Portuguese National Health System.
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