Normandie univ, UNICAEN, Inserm U1086, ANTICIPE, 14000 Caen, France.
Univ. Bordeaux, Inserm U1219, EPICENE, Cancer et expositions environnementales, 33000 Bordeaux, France.
J Gynecol Obstet Hum Reprod. 2021 Oct;50(8):102067. doi: 10.1016/j.jogoh.2021.102067. Epub 2021 Jan 21.
In France, termination of pregnancy (TOP) for medical reasons is legal, regardless of the term, after authorisation by a Multidisciplinary Centre for Prenatal Diagnosis (MCPD). This study analyses the elements supporting the TOP decision-making process faced with a foetal pathology.
Medical records of one MCPD were analysed for the period 2013 and 2014 and semi-structured interviews with MCPD members were conducted.
Out of 265 files concerning foetal indications, all but one resulted in a decision for TOP. The main indications in number for TOP were malformations and chromosomal abnormalities. For indications such as trisomy 21, authorisations are generally given without discussion. Our results underline the importance that professionals attach to the collegiality of decisions, particularly in situations of uncertainty.
This study provides information about the activity of MCPDs within the field of prenatal diagnosis and shows the importance of these structures in supporting women and couples whilst respecting their autonomy. At present, the role of the MCPD is in the process of evolving and could become an information and advisory board for women, based on collegial expertise to guide their decision-making.
在法国,无论孕期如何,只要获得多学科产前诊断中心(MCPD)的授权,因医疗原因终止妊娠(TOP)都是合法的。本研究分析了在胎儿病理学情况下支持 TOP 决策过程的要素。
对 2013 年至 2014 年期间一个 MCPD 的医疗记录进行了分析,并对 MCPD 成员进行了半结构化访谈。
在 265 份涉及胎儿指征的文件中,除 1 份外,其余均决定进行 TOP。TOP 的主要指征是畸形和染色体异常。对于 21 三体等指征,通常无需讨论即可获得授权。我们的研究结果强调了专业人员对决策集体性的重视,尤其是在不确定的情况下。
本研究提供了 MCPD 在产前诊断领域的活动信息,并展示了这些结构在尊重妇女和夫妇自主权的同时为其提供支持的重要性。目前,MCPD 的作用正在演变之中,并可能基于集体专业知识成为妇女的信息和咨询委员会,以指导她们的决策。