Non invaziv prenatal tanı testlerinin geleceği ve etik sorunlar
DOI:
https://doi.org/10.5281/zenodo.14588200Anahtar Kelimeler:
Non-invaziv prenatal testler, amniyosentez, koryon villus örneklemesi, cffDNA, etikÖzet
Non-invaziv prenatal testler kromozomal anormalliklerin tespitini daha güvenli, doğru ve erken hale getirerek prenatal tarama alanında devrim niteliğinde bir gelişme olarak ortaya çıkmıştır. NIPT, maternal kan örneğinde bulunan hücresiz fetal DNA'nın analiz edilmesini içermektedir. Faydalarına rağmen, Non-invaziv prenatal testlerin sınırlamaları vardır. Çoklu gebelik, düşük fetal fraksiyon ve annede obezite bunlardan bunlardandır. Non-invaziv prenatal testleri çevreleyen etik hususlar giderek daha fazla ilgi görmektedir. Non-invaziv prenatal testleri ilk olarak Ağustos 2011'de Hong Kong'da piyasaya sürülmüş, 2011'de ABD'de ticari olarak tanıtılmış, sonraki yıllarda piyasaya arz edilmiştir. Küresel non-invaziv prenatal testlerinin pazar değeri 2019 rakamlarıyla 3,5 milyar ABD doları civarındadır. Non-invaziv prenatal testleri gebeliklerde trizomilerin doğrulanması için birinci basamak tarama yöntemi olarak kabul edilmemektedir. Her ne kadar yanlış pozitif ve negatif sonuçların sıklığı düşük olsa da non-invaziv prenatal testlerinin trizomilerin teşhisinde kesin bir test olarak kabul etmemenin önündeki en önemli engel yanlış pozitif ve negatif sonuçlardır Non-invaziv prenatal testlerinin, tanı hatalarından kaçınmak ve daha güvenli analizi için USG gibi diğer doğum öncesi testlerle birlikte yapılması önerilmektedir. Non-invaziv prenatal testlerinin kullanımının yaygınlaşması ile dikkatli bir müzakere gerektiren derin etik endişeler gündeme getirilmiştir. Bu sorunlar özerklik, bilgilendirilmiş onam, ayrımcılık ve yaygın doğum öncesi taramanın potansiyel toplumsal etkileriyle ilgilidir. Bu derleme, non-invaziv prenatal testlerin klinik uygulamalarını, avantajlarını, sınırlamalarını ve etik kaygıları incelemeyi amaçlamaktadır.
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