Journal of the European Society for Gynaecological Endoscopy


The fetal patient – ethical aspects of fetal therapy

J. Deprest1, J. Toelen1, Z. Debyser2, C. Rodrigues6, R. Devlieger1, L. De Catte1, L. Lewi1, T. Van Mieghem1, G. Naulaers1, M. Vandevelde3, F. Claus5, K. Dierickx4

1Department of Woman and Child, 2Division of Molecular Medicine, 3Department of Anesthesiology, 4Centre for Bio- medical Ethics and Law, 5Department of Medical Imaging, University Hospitals Leuven, Katholieke Universiteit Leuven, Leuven, Belgium; 6Department of Obstetrics and Gynaecology, University Medical Centre Groningen, The Netherlands.

Correspondence at: Jan Deprest, Fetal Medicine, uZ Gasthuisberg, herestraat 49, leuven 3000, belgium. e-mail:; Tel.: +3216344215; Fax: +3216344205


Fetal therapy, fetal surgery, fetoscopy, prenatal diagnosis, trial, informed consent, termination of pregnancy

Published online: Oct 05 2011


The pregnant patient is a vulnerable subject, and even more so when a serious fetal condition is diagnosed. (Invasive) fetal therapy should only be offered when there is a good chance that the life of the fetus will be saved, or irreversible damage by the disease or disability is prevented. Following diagnosis of a potentially treatable condition, the patient needs to be referred to a center with sufficient expertise in diagnosis and all therapeutic options. Preferences of the physician towards one or another antenatal intervention is not at stake prior to that moment. When fetal therapy is justified, it should be offered with full respect for maternal choice and individual assessment and perception of potential risks, and should be at the location where there is sufficient expertise. For therapies of unproven benefit, the absence of evidence must be disclosed, and therapy should only be undertaken with full voluntary consent of the mother. These ought to be undertaken within well designed and approved trials and only by experts in the treatment modality. Potential risks and eventual morbidities in case of therapeutic failure should be part of the counselling, neither should fetal therapy be presented as an alternative to termination of pregnancy.