Abortion: the Unfinished Revolution
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Refusal to Undergo a Cesarean Section: a Woman's Right Or a Criminal Act ? Monica K
Health Matrix: The Journal of Law- Medicine Volume 15 | Issue 2 2005 Refusal to Undergo a Cesarean Section: A Woman's Right or a Criminal Act ? Monica K. Miller Follow this and additional works at: https://scholarlycommons.law.case.edu/healthmatrix Part of the Health Law and Policy Commons Recommended Citation Monica K. Miller, Refusal to Undergo a Cesarean Section: A Woman's Right or a Criminal Act ?, 15 Health Matrix 383 (2005) Available at: https://scholarlycommons.law.case.edu/healthmatrix/vol15/iss2/6 This Article is brought to you for free and open access by the Student Journals at Case Western Reserve University School of Law Scholarly Commons. It has been accepted for inclusion in Health Matrix: The ourJ nal of Law-Medicine by an authorized administrator of Case Western Reserve University School of Law Scholarly Commons. REFUSAL TO UNDERGO A CESAREAN SECTION: A WOMAN'S RIGHT OR A CRIMINAL ACT? Monica K. Millert INTRODUCTION In March, 2004, Melissa Ann Rowland, a twenty-eight-year-old woman from Salt Lake City, gained national media attention when she was arrested on charges of homicide relating to the death of her son. Although there are many child homicide cases that occur regularly across the country that do not attract wide-spread media attention, this case was exceptional because her son died before he was ever born. 1 Rowland had sought medical treatment several times between late December 2003 and January 9, 2004. Each time, she was allegedly advised to get immediate medical treatment, including a cesarean sec- tion (c-section), because her twin fetuses were in danger of death or serious injury. -
Clinical Policy: Fetal Surgery in Utero for Prenatally Diagnosed
Clinical Policy: Fetal Surgery in Utero for Prenatally Diagnosed Malformations Reference Number: CP.MP.129 Effective Date: 01/18 Coding Implications Last Review Date: 09/18 Revision Log Description This policy describes the medical necessity requirements for performing fetal surgery. This becomes an option when it is predicted that the fetus will not live long enough to survive delivery or after birth. Therefore, surgical intervention during pregnancy on the fetus is meant to correct problems that would be too advanced to correct after birth. Policy/Criteria I. It is the policy of Pennsylvania Health and Wellness® (PHW) that in-utero fetal surgery (IUFS) is medically necessary for any of the following: A. Sacrococcygeal teratoma (SCT) associated with fetal hydrops related to high output heart failure : SCT resecton: B. Lower urinary tract obstruction without multiple fetal abnormalities or chromosomal abnormalities: urinary decompression via vesico-amniotic shunting C. Ccongenital pulmonary airway malformation (CPAM) and extralobar bronchopulmonary sequestration with hydrops (hydrops fetalis): resection of malformed pulmonary tissue, or placement of a thoraco-amniotic shunt; D. Twin-twin transfusion syndrome (TTTS): treatment approach is dependent on Quintero stage, maternal signs and symptoms, gestational age and the availability of requisite technical expertise and include either: 1. Amnioreduction; or 2. Fetoscopic laser ablation, with or without amnioreduction when member is between 16 and 26 weeks gestation; E. Twin-reversed-arterial-perfusion (TRAP): ablation of anastomotic vessels of the acardiac twin (laser, radiofrequency ablation); F. Myelomeningocele repair when all of the following criteria are met: 1. Singleton pregnancy; 2. Upper boundary of myelomeningocele located between T1 and S1; 3. -
Fetal Surgery in Utero for Prenatally Diagnosed Malformations
Clinical Policy: Fetal Surgery in Utero for Prenatally Diagnosed Malformations Reference Number: PA.CP.MP.129 Effective Date: 01/18 Coding Implications Last Review Date: 12/18 Revision Log Description This policy describes the medical necessity requirements for performing fetal surgery. This becomes an option when it is predicted that the fetus will not live long enough to survive delivery or after birth. Therefore, surgical intervention during pregnancy on the fetus is meant to correct problems that would be too advanced to correct after birth. Policy/Criteria I. It is the policy of Pennsylvania Health and Wellness® (PHW) that in-utero fetal surgery (IUFS) is medically necessary for any of the following: A. Sacrococcygeal teratoma (SCT) associated with fetal hydrops related to high output heart failure : SCT resection; B. Lower urinary tract obstruction without multiple fetal abnormalities or chromosomal abnormalities: urinary decompression via vesico-amniotic shunting C. Congenital pulmonary airway malformation (CPAM) and extralobar bronchopulmonary sequestration with hydrops (hydrops fetalis): resection of malformed pulmonary tissue, or placement of a thoraco-amniotic shunt; D. Twin-twin transfusion syndrome (TTTS): treatment approach is dependent on Quintero stage, maternal signs and symptoms, gestational age and the availability of requisite technical expertise and include either: 1. Amnioreduction; or 2. Fetoscopic laser ablation, with or without amnioreduction when member is between 16 and 26 weeks gestation; E. Twin-reversed-arterial-perfusion (TRAP): ablation of anastomotic vessels of the acardiac twin (laser, radiofrequency ablation); F. Myelomeningocele repair when all of the following criteria are met: 1. Singleton pregnancy; 2. Upper boundary of myelomeningocele located between T1 and S1; 3. -
Update on Prenatal Diagnosis and Fetal Surgery for Myelomeningocele
Review Arch Argent Pediatr 2021;119(3):e215-e228 / e215 Update on prenatal diagnosis and fetal surgery for myelomeningocele César Meller, M.D.a, Delfina Covini, M.D.b, Horacio Aiello, M.D.a, Gustavo Izbizky, M.D.a, Santiago Portillo Medina, M.D.c and Lucas Otaño, M.D.a ABSTRACT This powered research in two A seminal study titled Management of critical areas. On the one side, prenatal Myelomeningocele Study, from 2011, demonstrated that prenatal myelomeningocele defect repaired myelomeningocele diagnosis within before 26 weeks of gestation improved the therapeutic window became a neurological outcomes; based on this study, fetal mandatory goal; therefore, research surgery was introduced as a standard of care efforts on screening strategies were alternative. Thus, prenatal myelomeningocele diagnosis within the therapeutic window became intensified, especially in the first a mandatory goal; therefore, research efforts on trimester. On the other side, different screening strategies were intensified, especially fetal surgery techniques were assessed in the first trimester. In addition, different fetal to improve neurological outcomes and surgery techniques were developed to improve neurological outcomes and reduce maternal reduce maternal risks. The objective risks. The objective of this review is to provide an of this review is to provide an update update on the advances in prenatal screening and on the advances in prenatal screening diagnosis during the first and second trimesters, and diagnosis and in fetal surgery for and in open and fetoscopic fetal surgery for myelomeningocele. myelomeningocele. Key words: myelomeningocele, fetal therapies, spina bifida, fetoscopy, antenatal care. EPIDEMIOLOGY The prevalence of spina bifida http://dx.doi.org/10.5546/aap.2021.eng.e215 varies markedly worldwide based on ethnic and geographic To cite: Meller C, Covini D, Aiello H, Izbizky G, characteristics.8,9 In Argentina, since et al. -
CP.MP.129 Fetal Surgery in Utero
Clinical Policy: Fetal Surgery in Utero for Prenatally Diagnosed Malformations Reference Number: CP.MP.129 Coding Implications Date of Last Revision: 07/21 Revision Log See Important Reminder at the end of this policy for important regulatory and legal information. Description This policy describes the medical necessity requirements for performing fetal surgery. This becomes an option when it is predicted that the fetus will not live long enough to survive delivery or after birth. Therefore, surgical intervention during pregnancy on the fetus is meant to correct problems that would be too advanced to correct after birth. Policy/Criteria I. It is the policy of health plans affiliated with Centene Corporation® that in-utero fetal surgery (IUFS) is medically necessary for any of the following: A. Sacrococcygeal teratoma (SCT): SCT resection or a minimally invasive approach; B. Lower urinary tract obstruction without multiple fetal anomalies or chromosomal abnormalities: urinary decompression via vesico-amniotic shunting; C. Congenital pulmonary airway malformation (CPAM) and extralobar bronchopulmonary sequestration (BPS), with high risk tumors: resection of malformed pulmonary tissue, or placement of a thoraco-amniotic shunt; D. Placement of a thoraco-amniotic shunt for pleural effusion with or without secondary fetal hydrops; E. Twin-twin transfusion syndrome (TTTS): treatment approach is dependent on Quintero stage, maternal signs and symptoms, gestational age and the availability of requisite technical expertise and include either: 1. Amnioreduction; or 2. Fetoscopic laser ablation, with or without amnioreduction when pregnancy is between 16 and 26 weeks gestation; F. Twin-reversed-arterial-perfusion sequence (TRAP): ablation of anastomotic vessels of the acardiac twin (laser, radiofrequency ablation); G. -
Fetal Surgery for Prenatally Diagnosed Malformations
Medical Policy Joint Medical Policies are a source for BCBSM and BCN medical policy information only. These documents are not to be used to determine benefits or reimbursement. Please reference the appropriate certificate or contract for benefit information. This policy may be updated and is therefore subject to change. *Current Policy Effective Date: 5/1/21 (See policy history boxes for previous effective dates) Title: Fetal Surgery for Prenatally Diagnosed Malformations Description/Background Fetal surgery is being investigated for specific congenital abnormalities that are associated with a poor postnatal prognosis. Prenatal surgery typically involves opening the gravid uterus (with a Cesarean surgical incision), surgically correcting the abnormality, and returning the fetus to the uterus and restoring uterine closure. Minimally invasive procedures through single or multiple fetoscopic port incisions are performed more frequently than open fetal surgery. Background Most fetal anatomic malformations are best managed after birth. However, advances in methods of prenatal diagnosis, particularly prenatal ultrasound, have led to a new understanding of the natural history and physiologic outcomes of certain congenital anomalies. Fetal surgery is the logical extension of these diagnostic advances, related in part to technical advancement in anesthesia, tocolysis, and hysterotomy. This policy pertains to fetal surgery performed for the following clinical conditions: • Fetal Urinary Tract Obstruction Although few cases of prenatally diagnosed urinary tract obstruction require prenatal intervention, bilateral obstruction can lead to distention of the urinary bladder and is often associated with serious disease such as pulmonary hypoplasia secondary to oligohydramnios. Therefore, fetuses with bilateral obstruction, oligohydramnios, adequate renal function reserve, and no other lethal or chromosomal abnormalities may be candidates for fetal surgery. -
AMERICAN ACADEMY of PEDIATRICS Prenatal Screening
AMERICAN ACADEMY OF PEDIATRICS CLINICAL REPORT Guidance for the Clinician in Rendering Pediatric Care Christopher Cunniff, MD; and the Committee on Genetics Prenatal Screening and Diagnosis for Pediatricians ABSTRACT. The pediatrician who cares for a child ital adrenal hyperplasia. These procedures may be with a birth defect or genetic disorder may be in the best important to couples at increased risk of having chil- position to alert the family to the possibility of a recur- dren with genetic disorders, because without this rence of the same or similar problems in future offspring. information they might be unwilling to attempt a The family may wish to know about and may benefit pregnancy. from methods that convert probability statements about A number of well-studied techniques are used for recurrence risks into more precise knowledge about a specific abnormality in the fetus. The pediatrician also prenatal diagnosis. For many of these techniques, the may be called on to discuss abnormal prenatal test results accuracy, reliability, and safety of the procedures are as a way of understanding the risks and complications positively correlated with operator experience. Pro- that the newborn infant may face. Along with the in- cedures such as amniocentesis, chorionic villus sam- crease in knowledge brought about by the sequencing of pling (CVS), fetal blood sampling, and preimplanta- the human genome, there has been an increase in the tion genetic diagnosis (PGD) allow analysis of technical capabilities for diagnosing many chromosome embryonic or fetal cells or tissues for chromosomal, abnormalities, genetic disorders, and isolated birth de- genetic, and biochemical abnormalities. Fetal imag- fects in the prenatal period. -
61956 Federal Register / Vol
61956 Federal Register / Vol. 67, No. 191 / Wednesday, October 2, 2002 / Rules and Regulations DEPARTMENT OF HEALTH AND I. Background income child, and her child would HUMAN SERVICES Section 4901 of the Balanced Budget benefit from needed prenatal care and Act, (Pub. L. 105–33), as amended by delivery services by virtue of the Centers for Medicare and Medicaid Public Law 105–100, added title XXI to mother’s eligibility status, a pregnant Services the Act. Title XXI authorizes the State woman over age 19 could not be eligible Children’s Health Insurance Program as a targeted low-income child. 42 CFR Part 457 We stated that the proposed definition (SCHIP) to assist State efforts to initiate would provide States with the option to and expand the provision of child consider an unborn child to be a [CMS–2127–F] health assistance to uninsured, low- targeted low-income child and therefore income children. Under title XXI, States eligible for SCHIP if other applicable RIN 0938–AL37 may provide child health assistance State eligibility requirements are met. primarily for obtaining health benefits This would permit States to ensure that State Children’s Health Insurance coverage through (1) a separate child Program; Eligibility for Prenatal Care needed services are available to benefit health program that meets the unborn children independent of the and Other Health Services for Unborn requirements specified under section Children mother’s eligibility status. We also 2103 of the Act; (2) expanding eligibility discussed in detail the Department’s AGENCY: Centers for Medicare & for benefits under the State’s Medicaid 1999 report, Trends in the Well-Being of Medicaid Services (CMS), HHS. -
Intrauterine Fetal Surgery – Commercial Medical Policy
UnitedHealthcare® Commercial Medical Policy Intrauterine Fetal Surgery Policy Number: 2021T0035V Effective Date: September 1, 2021 Instructions for Use Table of Contents Page Community Plan Policy Coverage Rationale ....................................................................... 1 • Intrauterine Fetal Surgery Applicable Codes .......................................................................... 1 Description of Services ................................................................. 2 Benefit Considerations .................................................................. 4 Clinical Evidence ........................................................................... 4 U.S. Food and Drug Administration ........................................... 13 References ................................................................................... 13 Policy History/Revision Information ........................................... 16 Instructions for Use ..................................................................... 16 Coverage Rationale See Benefit Considerations Intrauterine fetal surgery (IUFS) is proven and medically necessary for treating the following conditions: Congenital Cystic Adenomatoid Malformation (CCAM) and Extralobar Pulmonary Sequestration (EPS): Fetal lobectomy or thoracoamniotic shunt placement for CCAM and thoracoamniotic shunt placement for EPS Pleural Effusion: Thoracoamniotic shunt placement Sacrococcygeal Teratoma (SCT): SCT resection Urinary Tract Obstruction (UTO): Urinary decompression via vesicoamniotic -
![Fetal Surgery [1]](https://docslib.b-cdn.net/cover/7450/fetal-surgery-1-4277450.webp)
Fetal Surgery [1]
Published on The Embryo Project Encyclopedia (https://embryo.asu.edu) Fetal Surgery [1] By: O'Connor, Kathleen O'Neil, Erica Keywords: Medical procedures [2] Fetus [3] Fetal surgeries are a range of medical interventions performed in utero on the developing fetus [4] of a pregnant woman to treat a number of congential abnormalities. The first documented fetal surgical procedure occurred in 1963 in Auckland, New Zealand when A. William Liley treated fetal hemolytic anemia [5], or Rh disease, with a blood transfusion. Three surgical techniques comprise many fetal surgeries: hysterotomy, or open abdominal surgery performed on the pregnant woman; fetoscopy, for which doctors use a fiber-optic endoscope to view and make repairs to abnormalities in the fetus [4]; and percutaneous fetal therapy, for which doctors use a catheter to drain excess fluid. As the sophistication of surgical and neonatal technology advanced in the late twentieth century, so too did the number of congenital disorders fetal surgeons treated, such as mylomeningeocele, blocked urinary tracts, twin-to-twin transfusion syndrome [6], polyhydramnios, diaphragmatic hernia, tracheal occlusion, and other anomalies. Many discuss the ethics of fetal surgery, as many consider it contentious, as fetal surgery risks both the developing fetus [4] and the pregnant woman, and at times it only marginally improves patient outcomes. Some argue, hoowever, that as more advanced diagnostic equipment and surgical methods improve, advanced clinical trials in a few conditions may demonstrate more benefits than risks to both pregnant women and their fetuses. Fetal surgery is often performed to drain blocked bladders, repair heart valves, spinal openings, and remove abnormal growths from fetal lungs. -
Midwest Fetal Care Center
MIDWEST FETAL CARE CENTER The region’s leader in the diagnosis and treatment of congenital conditions and abnormalities in unborn infants. midwestfetalcarecenter.org OVERVIEW Midwest Fetal Care Center offers mothers with high-risk pregnancies and babies with complex conditions a continuum of care that is among the best in the nation. As the only advanced fetal care center in the Upper Midwest — and one of only a few in United States — Midwest Fetal Care Center brings together maternal fetal experts and the latest technology and treatments in a coordinated setting. From prenatal diagnosis and fetal treatment, to delivery, postnatal care and long-term follow-up, we are with our patients every step of the way. Our mission is to provide patients and families with an exceptional experience with the best possible outcome. Located at The Mother Baby Center in Minneapolis, Minnesota, the Midwest Fetal Care Center is a collaboration between Children’s Minnesota and Allina Health, bringing together a comprehensive team of maternal, fetal, neonatal and pediatric experts. Services From evaluation and diagnosis to fetal surgery and follow-up care, Midwest Fetal Care Center offers mothers and babies the highly trained experts and cutting-edge technology they need in one convenient location. Through our concierge care model, we communicate every step of our care plan to both patients and referring physicians, ensuring everyone is apprised of progress. Diagnostic services Fetal interventions Concierge care model Ultrasound Our care for babies who have -
INTRAUTERINE FETAL SURGERY Policy Number: MATERNITY 024.14 T2 Effective Date: June 1, 2018
UnitedHealthcare® Oxford Clinical Policy INTRAUTERINE FETAL SURGERY Policy Number: MATERNITY 024.14 T2 Effective Date: June 1, 2018 Table of Contents Page Related Policies INSTRUCTIONS FOR USE .......................................... 1 None CONDITIONS OF COVERAGE ...................................... 1 BENEFIT CONSIDERATIONS ...................................... 2 COVERAGE RATIONALE ............................................. 2 APPLICABLE CODES ................................................. 2 DESCRIPTION OF SERVICES ...................................... 3 CLINICAL EVIDENCE ................................................. 4 U.S. FOOD AND DRUG ADMINISTRATION .................... 9 REFERENCES ........................................................... 9 POLICY HISTORY/REVISION INFORMATION ................ 10 INSTRUCTIONS FOR USE This Clinical Policy provides assistance in interpreting Oxford benefit plans. Unless otherwise stated, Oxford policies do not apply to Medicare Advantage members. Oxford reserves the right, in its sole discretion, to modify its policies as necessary. This Clinical Policy is provided for informational purposes. It does not constitute medical advice. The term Oxford includes Oxford Health Plans, LLC and all of its subsidiaries as appropriate for these policies. When deciding coverage, the member specific benefit plan document must be referenced. The terms of the member specific benefit plan document [e.g., Certificate of Coverage (COC), Schedule of Benefits (SOB), and/or Summary Plan Description (SPD)]