Termination of pregnancy following prenatal diagnosis and legal status

Year 2012, Volume: 10 Issue: Özel Sayı, 83 - 93, 01.11.2012

Aytül Çorbacıoğlu Esmer Atıl Yüksel

Abstract

Today, it is possible to prenatally diagnose many fetal disorders using various methods such as fetal ultrasonography, magnetic resonance imaging (MRI), cytogenetic and moleculer analyses. In case of family’s request, pregnancies can be terminated due to congenital diseases which are lethal or which cause severe mental and/or physical and/or functional morbidity. These diseases are mainly; congenital anomalies, chromosomal diseases and single gene disorders. Late termination of pregnancy refers to the termination process performed after the gestational age at which fetus becomes viable, and unlike early termination, feticide (the cessation of fetal heart activity via intracardiac potassium chloride injection) is needed in addition to the induction of labor. Termination of pregnancy due to prenatal diagnosis, especially the late termination, has been a topic of ethical and legal concern. In this review, fetal diseases that result in termination of pregnancy, the preventable and inevitable causes of late termination, the termination procedures peculiar to multiple pregnancies and the importance of postmortem fetal examination are adressed. Furthermore, the legal applications in Turkey and in the world are summarized, the defects of the statute in our country are discussed and recommendations for qualified service are made.

Keywords

Prenatal diagnosis, legal status, congenital anomalies

Prenatal tanı sonrası gebeliklerin sonlandırılması ve yasal durum

Abstract

Günümüzde fetal ultrasonografi, manyetik rezonans görüntüleme (MR), sitogenetik ve moleküler incelemeler gibi çeşitli yöntemlerle çok sayıda fetal hastalığa prenatal tanı koyma olanağı mevcuttur. Letal ya da ciddi mental ve/veya fiziksel ve/veya fonksiyonel morbiditeye neden olan konjenital hastalıklar nedeniyle ailenin isteği doğrultusunda gebelikler sonlandırılabilmektedir. Bu hastalıklar basitçe; konjenital anomaliler, kromozom hastalıkları ve tek gen hastalıklarıdır. Gebeliğin geç sonlandırılması fetüsün viyabıl olduğu gestasyonel haftadan sonra yapılan tahliyelere verilen isimdir ve erken gebelik sonlandırmalarından farklı olarak doğum eyleminin indüksiyonuna ek olarak fetosit yapılması (intrakardiak postayum klorür enjeksiyonu ile fetal kalp aktivitesinin durdurulması) gerekli olmaktadır. Prenatal tanı sonrası gebeliklerin sonlandırması, özellikle de geç sonlandırma, etik ve yasal tartışmalara konu olmaktadır. Bu derlemede gebeliğin sonlandırılmasına neden olan fetal hastalıklar, geç sonlandırmanın önlenebilir ve kaçınılmaz nedenleri, çoğul gebeliklere özgü sonlandırma prosedürleri ve fetüsün postmortem incelenmesinin önemi irdelenmektedir. Ayrıca ülkemiz ve dünyadaki yasal uygulamalar özetlenmekte, yurdumuzda bu konuyla ilgili tüzüğün eksiklikleri tartışılmakta ve nitelikli hizmet için öneriler getirilmektedir.

Keywords

Prenatal tanı, konjenital anomaliler, yasal durum

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