Parental request for non-resuscitation in fetal myelomeningocele repair: an analysis of the novel ethical tensions in fetal intervention

J Perinatol. 2022 Jul;42(7):856-859. doi: 10.1038/s41372-022-01317-5. Epub 2022 Jan 14.

Abstract

As the field of fetal intervention grows, novel ethical tensions will arise. We present a case of Fetal myelomeningocele repair involving a 25-week fetus where parents requested that if emergent delivery was necessary during the open uterine procedure, that the medical team did not perform resuscitation. This question brings forward an important discussion around the complicated space of maternal autonomy, child rights, and clinician obligations that exists in fetal intervention. In some regions, a mother in this situation may choose to terminate the pregnancy. Parents could also choose not to do the surgery. Parents in some regions could opt for no resuscitation of a child born at 25-weeks' gestation. We offer an analysis of these relevant considerations, the different tensions, and the conflicting duties between the mother, fetus, and medical team. This analysis will provide ethical and clinical guidance for future questions that may arise in this burgeoning field.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Child
  • Female
  • Fetus / surgery
  • Gestational Age
  • Humans
  • Meningomyelocele* / surgery
  • Parents
  • Pregnancy
  • Prenatal Care