« Affiner le risque » : les gynécologues-obstétriciens et la gestion des zones grises du dépistage de la trisomie 21

• Main Author: Samuele Cavalli
• Format: Article
• Language: fra
• Published: Éditions de la Sorbonne 2014-06-01
• Series: Socio-anthropologie
• Subjects: prenatal screening; risk; uncertainty; ultrasound; gynaecologists-obstetricians
• Online Access: http://journals.openedition.org/socio-anthropologie/1717

During the medical monitoring of pregnancy, gynaecologists-obstetricians offer an invasive diagnostic test when the result of the Down syndrome screening shows a risk over the reference threshold, which is 1 in 380 in Switzerland. If the result of screening is situated in the grey zone around the threshold, professionals can resort to a complementary ultrasound, which allows clarifying the individual risk through a modification of the probability denominator. However, this ultrasound still can not offer a sure diagnosis of handicap. This proceeding provides an emblematic illustration of the tension between the possibility of control given by prenatal screening and the limits of probabilistic information. Based on a qualitative study with fifty-four gynaecologists-obstetricians the author analyses the different management strategies of this tension, focused on the grey zones of screening.