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Termination of pregnancy for fetal abnormalities: main arguments and a decision‐tree model
Author(s) -
Semir Köse,
Sabahattin Altunyurt,
Nuri Yıldırım,
Pembe Keskįnoğlu,
Tufan Çankaya,
Elçin Bora,
Derya Erçal,
Erdener Özer
Publication year - 2015
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.4662
Subject(s) - abnormality , referral , fetus , pregnancy , medicine , gestational age , prenatal diagnosis , chromosomal abnormality , retrospective cohort study , pediatrics , obstetrics , psychology , psychiatry , family medicine , surgery , genetics , karyotype , biology , gene , chromosome
By looking through our ethical committee cases, we demonstrate the main arguments we use for making a judgment in face of fetal abnormalities. Our decision making model is a simplified algorithm of the arguments and concepts we use in scientific‐ethic discussion. Materials and Methods A retrospective analysis was conducted from single, tertiary referral center of patients evaluated for fetal abnormalities from 2004 to 2014. We hypothesized that all our judgments would fit into a decision‐tree model. Results 553 fetal abnormality cases were discussed, 348 (63%) were given termination of pregnancy (TOP) proposal. When detected <24 weeks, fetuses with chromosomal abnormality/genetic disorders ( n :100) and with mental retardation risk ( n :93) ended up with TOP proposal. For incompatibility with life cases ( n :111) and the multimorbidity cases ( n :44) the committee suggest TOP, regardless of gestational age. The highest family approval ratios were in chromosomal abnormalities/genetic disorders group (93%), and the lowest figures were in mental retardation risk group (80%). Discussion Continuously changing literature on prenatal and postnatal therapy options and the long term outcome of various fetal abnormalities influence committee decisions. Theoretical high success rates and inconsistent data on long term prognosis of some anomaly groups resulted in heterogenous decisions and various approval ratios. © 2015 John Wiley & Sons, Ltd.