Maternal-Fetal Intervention and Fetal Care Centers

The past 2 decades have yielded profound advances in the fields of prenatal diagnosis and fetal intervention. Although fetal interventions are driven by a beneficence-based motivation to improve fetal and neonatal outcomes, advancement in fetal therapies raises ethical issues surrounding maternal autonomy and decision-making, concepts of innovation versus research, and organizational aspects within institutions in the development of fetal care centers. To safeguard the interests of both the pregnant woman and the fetus, the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics make recommendations regarding informed consent, the role of research subject advocates and other independent advocates, the availability of support services, the multidisciplinary nature of fetal intervention teams, the oversight of centers, and the need to accumulate maternal and fetal outcome data.

[1]  Rebecca Kukla,et al.  Risk and the Pregnant Body , 2009, The Hastings Center report.

[2]  A. Baschat,et al.  Fetal intervention: providing reasonable access to quality care. , 2009, Obstetrics and gynecology.

[3]  ACOG Committee Opinion No. 439: Informed consent. , 2009, Obstetrics and gynecology.

[4]  A. Lyerly,et al.  Paediatrics‐based fetal care: unanswered ethical questions , 2008, Acta paediatrica.

[5]  T. Crombleholme,et al.  Acute effects of selective fetoscopic laser photocoagulation on recipient cardiac function in twin-twin transfusion syndrome. , 2008, American journal of obstetrics and gynecology.

[6]  T. Silber.  Human gene therapy, consent, and the realities of clinical research: is it time for a research subject advocate? , 2008, Human gene therapy.

[7]  M. Bebbington,et al.  Liver position and lung-to-head ratio for prediction of extracorporeal membrane oxygenation and survival in isolated left congenital diaphragmatic hernia. , 2007, American journal of obstetrics and gynecology.

[8]  Gynecologists.  ACOG Committee Opinion No. 377: Research involving women. , 2007, Obstetrics and gynecology.

[9]  M. Douglas,et al.  Maternal autonomy: ethics and the law. , 2006, International journal of obstetric anesthesia.

[10]  ACOG Committee Opinion No. 352: Innovative practice: ethical guidelines. , 2006, Obstetrics and gynecology.

[11]  T. Crombleholme,et al.  Reproductive outcomes after pregnancy complicated by maternal-fetal surgery. , 2004, American journal of obstetrics and gynecology.

[12]  K. Neill.  Research Subject Advocate: A New Protector of Research Participants , 2003, Accountability in research.

[13]  A. Lyerly,et al.  Toward the ethical evaluation and use of maternal-fetal surgery. , 2001, Obstetrics and gynecology.

[14]  S. Goodman,et al.  What patients say about medical research. , 1998, IRB.

[15]  J. Bermúdez.  The Moral Significance of Birth , 1996, Ethics.

[16]  L. Emmanuel.  Feminist Perspectives in Medical Ethics , 1993 .

[17]  Helen Bequaert Holmes,et al.  Feminist perspectives in medical ethics , 1992 .

[18]  P S Appelbaum,et al.  False hopes and best data: consent to research and the therapeutic misconception. , 1987, The Hastings Center report.