题名

新興產前遺傳檢測之臨床運用及倫理考量

并列篇名

Innovative Prenatal Testing: Clinical Applications and Ethical Considerations

DOI

10.6224/JN.000062

作者

黃美智(Mei-Chih Huang);林秀娟(Shio-Jean Lin);陳祉伶(Chih-Ling Chen);黃子容(Tzu-Jung Huang)

关键词

新興產前遺傳檢測 ; 非侵入性胎兒染色體檢測 ; 游離胎兒DNA染色體異常母血篩檢 ; 倫理考量 ; innovative prenatal testing ; non-invasive prenatal testing ; cell-free DNA screening for fetal aneuploidy ; ethical consideration

期刊名称

護理雜誌

卷期/出版年月

64卷5期(2017 / 10 / 01)

页次

5 - 10

内容语文

繁體中文

中文摘要

藉由生物醫學科技之快速發展,新增許多產前遺傳檢測項目以積極協助孕婦增加對於其懷孕胎兒的了解。而市面亦常見各類針對孕婦產前檢驗的廣告。其中非侵入性胎兒染色體檢測提出可早期、安全又準確的檢測胎兒染色體異常疾病,此新興產前遺傳檢測究竟是指哪個項目?其適用性有何特殊考量?有哪些倫理考量或政策議題是需要去關注的?本文提供新興產前遺傳檢測之相關資訊、臨床指引及其倫理與政策議題,並以案例分析呈現不同情境之執行要點,期能有助於提升對於新時代遺傳檢測於孕產婦照護之多元資訊,以利提升產科照護之品質。

英文摘要

The biomedical technology related to prenatal screen/diagnosis has developed rapidly in recent decades. Many prenatal genetic examinations are now available to assist pregnant women to better understand the status and development of their fetus. Moreover, many commercial advertisements for innovative prenatal examinations are now shown in the media. Cell-free DNA Screening (cfDNA screening), a non-invasive prenatal testing (NIPT) procedure, is a safe and high accuracy test that may be done at an earlier gestational age to screen for fetal aneuploidy. The following questions should be considered when applying cfDNA screening in clinical practice: 1. what is cfDNA screening, 2. who are its potential users, and 3. what ethical and policy considerations are associated with this examination? This article provides relevant information, clinical practice guidelines, and ethical/ policy considerations related to cfDNA screening. Discussing cases involving different clinical situations helps promote understanding of cfDNA screening and maternal-care quality.

主题分类 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
参考文献
  1. 台大醫院基因醫學部細胞遺傳檢驗室(無日期).非侵入性胎兒染色體基因檢測(NIPT).取自https://www.ntuh.gov.tw/gene/lab/prenatal/Pages/NIPT.aspx [Department of Medical Genetics, National Taiwan University Hospital. (n.d.). Non-invasive prenatal testing (NIPT). Retrieve from https://www.ntuh.gov.tw/gene/lab/prenatal/Pages/NIPT.aspx]
  2. de Jong, A.,de Wert, G. M. W. R.(2015).Prenatal screening: An ethical agenda for the near future.Bioethics,29(1),46-55.
  3. Deans, Z.,Clarke, A. J.,Newson, A. J.(2015).For your interest? The ethical acceptability of using non-invasive prenatal testing to test 'purely for information'.Bioethics,29(1),19-25.
  4. Dondorp, W.,de Wert, G.,Bombard, Y.,Bianchi, D. W.,Bergmann, C.,Borry, P.,American Society of Human Genetics(2015).Non-invasive prenatal testing for aneuploidy and beyond: Challenges of responsible innovation in prenatal screening.European Journal of Human Genetics,23(11),1438-1450.
  5. Mikamo, S.,Nakatsuka, M.(2015).Knowledge and attitudes toward non-invasive prenatal testing among pregnant Japanese women.Acta Medica Okayama,69(3),155-163.
  6. Samura, O.,Sekizawa, A.,Suzumori, N.,Sasaki, A.,Wada, S.,Hamanoue, H.,Sago, H.(2017).Current status of non-invasive prenatal testing in Japan.The Journal of Obstetrics and Gynaecology Research,43(8),1245-1255.
  7. Stapleton, G.(2017).Qualifying choice: Ethical reflection on the scope of prenatal screening.Medicine, Health Care and Philosophy,20(2),195-205.
  8. Taneja, P. A.,Snyder, H. L.,de Feo, E.,Kruglyak, K. M.,Halks-Miller, M.,Curnow, K. J.,Bhatt, S.(2016).Noninvasive prenatal testing in the general obstetric population: Clinical performance and counseling considerations in over 85000 cases.Prenatal Diagnosis,36(3),237-243.
  9. Vanstone, M.,King, C.,de Vrijer, B.,Nisker, J.(2014).Noninvasive prenatal testing: Ethics and policy considerations.Journal of Obstetrics and Gynaecology Canada,36(6),515-526.
  10. Yotsumoto, J.,Sekizawa, A.,Suzumori, N.,Yamada, T.,Samura, O.,Nishiyama, M.,Japan NIPT Consortium(2016).A survey on awareness of genetic counseling for noninvasive prenatal testing: The first year experience in Japan.Journal of Human Genetics,61(12),995-1001.
  11. 呂宜珍、林秀娟、黃美智(2003)。新生兒篩檢之社會衝擊與倫理考量。台灣醫學,7(5),774-779。
  12. 奇美醫院遺傳諮詢中心(2017)。新興產前遺傳檢測─指引及諮詢參考手冊。台南市=Tainan City, Taiwan, ROC:奇美醫療財團法人奇美醫院=Chi-Mei Hospital。
  13. 國民健康署(2017)。孕婦健康手冊。台北市=Taipei City, Taiwan, ROC:作者=Author。
被引用次数
  1. 王筱君(Hsiao-Chun Wang);陳嬿如(Yen-Ju Chen)(2023)。運用共享決策於一位早期破水且胎兒染色體異常婦女之護理經驗。彰化護理。30(2)。76-88。