Termination of pregnancy for foetal indication in the French context analysis of decision-making in a Multidisciplinary Centre For Prenatal Diagnosis

Abstract The previous article described a new approach methodology1 for work on the development of technology for the use of the SCR CRABE SCUBA2 type diving apparatus. However, after its publication numerous questions emerged regarding the genesis of the research undertaken, also from foreign partners using the same rebreather. The work on changing the technology of use was preceded by analyses, which were available only to people involved in the decision-making process. Demonstrating all the details of the decision-making process may be tedious, but failing to present them at all might raise justified doubts about the advisability of conducting a long-term research cycle. This article only presents preliminary analyses. The necessity to perform them resulted from the specific requirements for military technologies3 which, as broadly as possible, should be knowledge-based. The knowledge-based approach by its very nature allows continuous improvement of the adequacy of the predictions made, the estimation of the level of risk when diagnosing deviations from the repeatability or precision of the model, and the possibility of adapting the technology to the changing requirements of the user resulting from tactical considerations of its use.

Download Full-text

Prenatal Genetic Diagnosis for Pediatricians

PEDIATRICS ◽

10.1542/peds.93.6.1010 ◽

1994 ◽

Vol 93 (6) ◽

pp. 1010-1015

Author(s):

Keyword(s):

Decision Making ◽

Genetic Counseling ◽

Prenatal Diagnosis ◽

Diagnostic Tests ◽

Genetic Disorder ◽

Genetic Diagnosis ◽

Decision Making Process ◽

Know How ◽

Prenatal Genetic Diagnosis ◽

The Family

Pediatricians may be called upon to counsel a family in which prenatal diagnosis is being considered or in which there is a fetus with a genetic disorder. In some settings, the pediatrician may be the primary resource for counseling the family. More frequently, counseling may already have been provided by a clinical geneticist and/or obstetrician. However, because of a previous relationship with the family, the pediatrician may be called upon to review this information and to assist the family in the decision-making process. The pediatrician should be familiar with the principles of prenatal genetic diagnosis and know how to apply them to specific problems in genetic counseling, diagnosis, and management in clinical practice. At the same time, pediatricians should be familiar with resources available in their region for obtaining information about whether and how a specific disorder can be diagnosed and when and where to refer patients for prenatal genetic diagnosis. The technology of prenatal diagnosis is changing rapidly, and genetic consultants can assist pediatricians in the appropriate utilization and interpretation of the diagnostic tests that are available.

Download Full-text

Attitudes to prenatal diagnosis and termination of pregnancy for 30 conditions among women in Saudi Arabia and the UK

Prenatal Diagnosis ◽

10.1002/pd.3967 ◽

2012 ◽

Vol 32 (11) ◽

pp. 1109-1113 ◽

Cited By ~ 18

Author(s):

Ayman Alsulaiman ◽

Jenny Hewison ◽

Khaled K. Abu-Amero ◽

Shenaz Ahmed ◽

Josephine M. Green ◽

...

Keyword(s):

Saudi Arabia ◽

Prenatal Diagnosis ◽

Termination Of Pregnancy ◽

The Uk

Download Full-text

Decision-making after prenatal diagnosis of a syndrome predisposing to intellectual disability: What prospective parents need to know and the importance of non-medical information

Journal of Intellectual & Developmental Disability ◽

10.3109/13668250.2012.726350 ◽

2012 ◽

Vol 37 (4) ◽

pp. 315-323 ◽

Cited By ~ 1

Author(s):

Caroline Huyard

Keyword(s):

Decision Making ◽

Intellectual Disability ◽

Prenatal Diagnosis ◽

Medical Information ◽

Prospective Parents

Download Full-text

How will new genetic technologies, such as gene editing, change reproductive decision-making? Views of high-risk couples

European Journal of Human Genetics ◽

10.1038/s41431-020-00706-8 ◽

2020 ◽

Vol 29 (1) ◽

pp. 39-50

Author(s):

Ivy van Dijke ◽

Phillis Lakeman ◽

Inge B. Mathijssen ◽

Mariëtte Goddijn ◽

Martina C. Cornel ◽

...

Keyword(s):

Decision Making ◽

Prenatal Diagnosis ◽

High Risk ◽

Gene Editing ◽

Genetic Disorder ◽

Clinical Genetics ◽

Reproductive Decision ◽

Reproductive Decision Making ◽

Increased Risk ◽

Genetic Technologies

AbstractCouples at increased risk of having offspring with a specific genetic disorder who want to avoid having an affected child have several reproductive options including prenatal diagnosis (PND) and preimplantation genetic testing (PGT). In the future, non-invasive prenatal diagnosis (NIPD), germline gene editing (GGE) and somatic gene editing (SGE) might become available. This study explores if, and how, availability of new genetic technologies, including NIPD, GGE, SGE, would change reproductive decision-making of high-risk couples. In 2018, semi-structured interviews were conducted with 25 genetically at-risk couples. Couples previously had received genetic counselling for PND and PGT, and in most cases opted for (one of) these techniques, at one Dutch Clinical Genetics Center between 2013 and 2017. Considerations participants mentioned regarding the hypothetical use of NIPD, GGE and SGE, seem similar to considerations regarding PND and PGT and are reflected in underlying concepts. These include safety and burden for mother and child, and moral considerations. Couples generally favoured NIPD over PND as this would be safe and enables earlier diagnosis. Increased opportunities of having a ‘healthy’ embryo and less embryo disposal were considerations in favour of GGE. Some regarded GGE as unsafe and feared slippery slope scenarios. Couples were least favourable towards SGE compared to choosing for a genetic reproductive technology, because of the perceived burden for the affected offspring. With the possibly growing number of technological options, understanding high risk couples’ perspectives can assist in navigating the reproductive decision-making process. Counsellors should be prepared to counsel on more and complex reproductive options.

Download Full-text