https://doi.org/10.4081/mem.1990.1169
Feto a rischio per iperplasia surrenalica congenita
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Autori
Gli autori discutono il caso clinico di una donna gravida di 21 anni, con un figlio maschio già nato affetto da una iperplasia surrenalica congenita dovuta al deficit di 21-idrossilasi. Nel corso dell'ottava settimana di gravidanza viene iniziata la somministrazione di glucocorticoidi nel sospetto che il feto potesse essere affetto dalla stessa malattia dell'altro figlio: la terapia viene continuata dopo conferma della malattia effettuata mediante diagnosi prenatale con prelievo dei villi coriali (CVS) alla 10a settimana. Tre problemi etici sono considerati: 1) il grado di accettabilità del rischio connesso con metodiche diagnostiche come la CVS; 2) il rapporto rischi/benefici per il nascituro e per la madre in relazione alla terapia attuata; 3) l'efficacia di una terapia che fosse iniziata dopo una diagnosi prenatale più tardiva ma effettuata con una tecnica meno rischiosa e più sicura, come l'amniocentesi. E' proposta, infine, la posizione personale degli autori in merito alla decisione etica in un caso come questo.
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