Ethical Considerations in Multiple Pregnancy: Preterm Delivery in the Setting of Discordant Fetal Anomaly
| Autor: | Thérèse Phillips, Stephen Cole, Bryanna Moore, Elske Posma, Rocco Cuzzilla, Lynn Gillam |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Gestational Age Ultrasonography Prenatal 03 medical and health sciences Fetus 0302 clinical medicine Traumatic grief Pregnancy Risk Factors Diseases in Twins Humans Medicine 030212 general & internal medicine Genetics (clinical) Twin Pregnancy 030219 obstetrics & reproductive medicine business.industry Obstetrics Infant Newborn Pregnancy Outcome Obstetrics and Gynecology Gestational age Twins Monozygotic medicine.disease Disadvantaged Pregnancy Complications Premature birth Vein of Galen Malformations Pediatrics Perinatology and Child Health Pregnancy Twin Premature Birth Gestation Female Pregnancy Multiple business |
| Zdroj: | Twin Research and Human Genetics. 22:120-123 |
| ISSN: | 1839-2628 1832-4274 |
| DOI: | 10.1017/thg.2019.12 |
| Popis: | Planning for the preterm birth of a fetus with known anomalies can raise complex ethical issues. This is particularly true of multiple pregnancies, where the interests of each fetus and of the expectant parent(s) can conflict. In these complex situations, parental wishes and values can also conflict with the recommendations of treating clinicians. In this article, we consider the case of a dichorionic twin pregnancy complicated by the diagnosis of vein of Galen aneurysmal malformation (VGAM) in one of the twins at 28 weeks’ gestation. Subsequent deterioration of the affected twin prompted the parents to request preterm delivery to prevent the imminent in-utero demise of the affected twin. However, given the associated risks of prematurity, complying with the parents’ request may have disadvantaged the health and wellbeing of the unaffected twin. This article canvases the complex ethical issues raised when parents request preterm delivery of a multiple pregnancy complicated by a fetal anomaly in one twin, and the various ethical tools and frameworks that clinicians can draw on to guide their decision-making in such cases. |
| Databáze: | OpenAIRE |
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