Prenatal diagnosis
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Free fetal DNA in maternal circulation: a potential prognostic marker for chromosomal abnormalities?
Previous studies on the association of fetal cell-free (cf)DNA levels in maternal circulation have produced conflicting results but the sample sizes were small and based on archived material. We aimed to quantify the levels of fetal and total cfDNA on prospectively collected samples, to understand their correlation with other variables and to clarify their diagnostic value. ⋯ Quantification of fetal and total cfDNA in maternal circulation showed inverse correlation between NT and total cfDNA levels. Our results also suggest that fetal cfDNA is not an ideal prognostic marker for chromosomal abnormalities in first-trimester pregnancies.
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Religion is believed to have a significant impact on individuals from minority ethnic groups when making decisions about prenatal genetic screening, prenatal diagnosis and termination of pregnancy. This study aimed to explore the views of individuals from South-Asian and African-Caribbean communities towards termination of pregnancy for sickle cell disorders and thalassaemia major and the influence of (1) faith and religion, (2) perceived severity of the conditions, and (3) religious and community leaders. ⋯ The findings emphasise the importance of recognising diversity within different faith groups and moving away from stereotypical views based on people's ethnicity or religion, and to consider the beliefs and preferences of individuals.
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This article reviews the current and potential laws relevant to post-implantation fetal social sex selection and considers whether they could provide an effective deterrent and control of the practice, if the United Kingdom decided that such control were desirable. It concludes that enacting, drafting and enforcing of any legislation throws up many difficult practical and ethical issues. These issues need to be debated and further information collected before any legislation is rushed into.
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The morality and acceptability of using prenatal diagnosis for sex selection is being extensively debated around the world as advances in assisted reproductive technologies (ART) and embryology have enabled selective implantation of embryos of the desired sex (George and Dahiya, 1998; Savulescu, 1999; Raphael, 2002; Harris, 2005; Robertson, 2005; Snider, 2005). Sophisticated methods of separation of semen, originally developed for cattle breeding, are being used for human sex selection. Recently, non-invasive methods of fetal sex determination in the first trimester (from 6 weeks) of pregnancy have also emerged (Hahn and Chitty, 2005). ⋯ Even if they believe that these trends will not affect mainstream Western societies, the promotion or tolerance of sex selection amounts to a 'crime of silence' against this ongoing genocide in China and India. I have been concerned with issues of the girl child in India for over two decades and sex selection among Asian Indians in North America (George et al., 1992; George et al., 1993; George and Dahiya, 1998). This article examines the missing millions of girls, but will not consider the 1980s campaign against fetal sex determination, Indian feminists' recognition of sex selection as violence against women (unlike several Western feminists, Moazam, 2004), or the Government's response to regulate prenatal diagnostic techniques in 1994 (George and Dahiya, 1998; George, 2002).
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Review
The obstetrician's view: ethical and societal implications of non-invasive prenatal diagnosis.
We believe non-invasive prenatal diagnosis is about to have a massive impact on the way fetal medicine is practised. There will be many great advantages and improvements, but the technology also has the potential to be used for non-medical reasons such as sex selection and paternity testing. We discuss some of the issues that may face obstetricians in the future as a result of this emerging technology.