الفهرس 
Fetal Medical TherapyOnly 14 pages are availabe for public view
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Abstract
Introduction & Aim of work: Fetal therapies fall into four categories: transplacental drug treatment, gene therapy, invasive procedures and fetal surgery. These present many common ethical issues, not least because a given form of therapy might involve one or more of the other procedures. Ethical concern is raised in three key areas: the balance of potential benefit and harm, autonomy and informed consent, and the duties of the clinician to the pregnant women and fetus. Invasive therapy should be recommended only when it has a realistic chance of saving the life of the fetus or preventing serious and irreversible disease or disability. In recommending fetal therapy of proven efficacy, clinicians should respect maternal choice and assessment of risk. Diagnostic and therapeutic procedures of unproven efficacy should be undertaken only with the voluntary informed consent of the pregnant woman and according to a clearly defined research protocol that has been approved by an appropriate research ethics committee. Treatment of several fetal disorders has been successfully achieved by either transplacental or direct fetal drug therapy. Many pharmacological aspects of such therapy require further study and there is a need for the benefits of certain drugs to be compared in randomized trials. The number of disorders currently amenable to drug treatment is small. However, advances in fetal medicine and pharmacology mean this number is likely to increase in the future. Fetal surgery typically involves surgically opening the pregnant uterus (through a traditional Cesarean surgical incision or via single or multiple fetoscopic port incisions), correcting a fetal abnormality, returning the fetus to the uterus and closing the uterus.
Conclusions: The ability to transfuse a fetus in utero is a brilliant technical achievement, in that a simple transfusion might enable the affected baby to survive a few more weeks and reach a stage of maturity when induction of labour would be safe. Fetal gene therapy would also introduce a third option for families faced with the prenatal diagnosis of a severe genetic disease where up to now acceptance of an affected child or termination of pregnancy are the only alternatives.