title: Termination of pregnancy for fetal abnormalities: main arguments and a decision-tree model.
abstract: BACKGROUND
  By looking through our ethical committee cases, we demonstrate the main arguments we use for making a judgment in face of fetal abnormalities. Our decision making model is a simplified algorithm of the arguments and concepts we use in scientific-ethic discussion.
  
  
  METHODS
  A retrospective analysis was conducted from single, tertiary referral center of patients evaluated for fetal abnormalities from 2004 to 2014. We hypothesized that all our judgments would fit into a decision-tree model.
  
  
  RESULTS
  553 fetal abnormality cases were discussed, 348 (63%) were given termination of pregnancy (TOP) proposal. When detected <24 weeks, fetuses with chromosomal abnormality/genetic disorders (n:100) and with mental retardation risk (n:93) ended up with TOP proposal. For incompatibility with life cases (n:111) and the multimorbidity cases (n:44) the committee suggest TOP, regardless of gestational age. The highest family approval ratios were in chromosomal abnormalities/genetic disorders group (93%), and the lowest figures were in mental retardation risk group (80%).
  
  
  CONCLUSIONS
  Continuously changing literature on prenatal and postnatal therapy options and the long term outcome of various fetal abnormalities influence committee decisions. Theoretical high success rates and inconsistent data on long term prognosis of some anomaly groups resulted in heterogenous decisions and various approval ratios.
authors.forename: Semir
authors.initials: S
authors.lastname: Kose
authors.forename: Sabahattin
authors.initials: S
authors.lastname: Altunyurt
authors.forename: Nuri
authors.initials: N
authors.lastname: Yıldırım
authors.forename: Pembe
authors.initials: P
authors.lastname: Keskinoğlu
authors.forename: Tufan
authors.initials: T
authors.lastname: Çankaya
authors.forename: Elçin
authors.initials: E
authors.lastname: Bora
authors.forename: Derya
authors.initials: D
authors.lastname: Erçal
authors.forename: Erdener
authors.initials: E
authors.lastname: Özer
mesh_terms: D000015:Abnormalities, Multiple; D000028:Abortion, Induced; D000293:Adolescent; D000328:Adult; D000465:Algorithms; D002869:Chromosome Aberrations; D025063:Chromosome Disorders; D000013:Congenital Abnormalities; D003657:Decision Making; D003663:Decision Trees; D005260:Female; D030342:Genetic Diseases, Inborn; D006801:Humans; D008607:Intellectual Disability; D008875:Middle Aged; D010290:Parents; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult