Pre-natal screening seeks to establish a risk profile to enable prevention, early diagnosis and early treatment. It is carried by taking family history, screening of blood, molecular tests, and ultrasound examination. The results of screening could precipitate unethical actions by parents. Informed consent should be obtained before undertaking some forms of screening such as ultrasound examination because the parents may not be ready for adverse results.

Pre-natal genetic screening

Pre-natal genetic screening using amniocentesis or chorionic villous sampling is carried out for women with a known high risk of carrying a genetically-abnormal baby. The risk may be known from adverse outcome in previous pregnancies or family history. Genetic screening should be undertaken with the purpose of knowing the genetic disorder in advance in order to prepare psychologically and financially for birth of an abnormal child. It should not be undertaken with the intention of pregnancy termination if adverse conditions are found.

Pre-natal diagnosis

The reasons for pre-natal diagnosis are: reassurance, desire for termination, preparation for abnormal birth (financially and psychologically), and in-utero treatment for example congenital adrenal hyperplasia. Methods of pre-natal diagnosis are: amniocentesis, chorionic villous sampling, percutaneous umbilical cord sampling, ultrasonography, CT and MRI. Amniocentesis is feasible after week 16 and cells obtained can be cultured. There is a risk that pre-natal diagnosis will be abused to terminate any pregnancy with an abnormality and this is a form of genocide. If it becomes widely available, pre-natal diagnosis could be abused by aborting perfectly normal children who happen not to have certain characteristics preferred by parents. Pre-natal diagnosis should therefore not be offered routinely.

Pre-natal treatment

This includes intrauterine fetal transfusion, intra-uterine surgery, intrauterine drug treatment of cardiac arrhyhthmias, and thyroid disorders.

Legal rulings

The principle of intention is the basic guideline for all issues of pre-natal screening and diagnosis. The procedures are allowed if carried out for purposes of reassurance, psychological or financial preparation for birth of an abnormal baby, or for starting early treatment. They are forbidden if the underlying intention is to commit abortion of abnormal fetuses. Under the principle of injury, the screening or diagnostic methods used must not harm the fetus or the mother.

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