Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology, and Women's Health, Saint Louis University School of Medicine, Saint Louis, MO, USA.
Northwell Health, Department of Obstetrics and Gynecology, Staten Island University Hospital, Staten Island, NY, USA.
Prenat Diagn. 2018 Apr;38(5):303-309. doi: 10.1002/pd.5225. Epub 2018 Mar 24.
To examine whether obstetricians think that cardiac surgery is ethical in babies with common aneuploidies and whether insurance companies should be required to pay for these surgeries.
A survey was e-mailed to 2897 OB-GYNs, and 898 (31%) actively practicing obstetricians responded to the survey. Respondents were asked whether it is ethical to offer cardiac surgery for babies with heart defects diagnosed with trisomies 21, 18, and 13 and Turner syndrome and whether insurance companies should be required to pay for such surgeries in cases of trisomy 18 or 13. Chi-square tests were utilized to compare responses by using an alpha level of .05.
Most obstetricians thought that offering cardiac surgery was ethical if the baby had trisomy 21 or Turner syndrome (94%), but not trisomy 18 or 13 (75%). Most obstetricians (69%) thought that insurance companies should not be legally required to pay for cardiac surgery for the latter group.
Obstetricians were more likely to think cardiac surgery was ethical if the prognosis or the outcome was good. Most respondents did not think that insurance companies should be required to subsidize the cost of cardiac surgeries for all babies with trisomy 18 or 13.
探讨妇产科医生是否认为心脏手术对于常见染色体异常婴儿是合乎伦理的，以及保险公司是否应该为此类手术买单。
对 2897 名妇产科医生进行了电子邮件调查，其中 898 名（31%）在职妇产科医生对调查做出了回应。调查询问了妇产科医生，如果婴儿患有唐氏综合征 21 号、18 号和 13 号以及特纳综合征导致的心脏缺陷，是否有必要提供心脏手术，以及在唐氏综合征 18 号或 13 号的情况下，保险公司是否应该为此类手术买单。采用卡方检验，使用.05 的显著性水平比较应答者的回答。
大多数妇产科医生认为，如果婴儿患有唐氏综合征 21 号或特纳综合征（94%），那么提供心脏手术是合乎伦理的，但如果婴儿患有唐氏综合征 18 号或 13 号（75%），则并非如此。大多数妇产科医生（69%）认为，对于后一组婴儿，保险公司不应该在法律上被要求支付心脏手术的费用。
如果预后或结果良好，妇产科医生更倾向于认为心脏手术是合乎伦理的。大多数受访者认为，保险公司不应该为所有患有唐氏综合征 18 号或 13 号的婴儿补贴心脏手术的费用。
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