Prenatal diagnosis is used to detect particularly serious diseases of genetic origin, infectious or otherwise, in the embryo or foetus in utero. The object is to be able to offer parents treatment for the unborn child or to help them prepare for his or her birth. Because of their seriousness and the fact they are incurable ; other affections will lead teams in multidisciplinary centres for prenatal diagnosis to inform couples of this situation. Beyond giving this information, the multidisciplinary centres for prenatal diagnosis alone are competent to certify as to the seriousness of the situation, so making a medical termination of a pregnancy legal. The couples then decide whether or not to continue with the pregnancy.
MULTIDISCIPLINARY CENTRES FOR PRENATAL DIAGNOSIS
In France there are roughly fifty multidisciplinary centres for prenatal diagnosis. Professionals in the teams include gynaecologists and obstetricians, sonographers, paediatricians, geneticists, psychiatrists or psychologists, foetal pathologists and genetics counsellors. These multidisciplinary teams support and counsel couples. They also have the mission of confirming indications, giving opinions and advice (diagnostic, therapeutic and prognostic) to clinicians and biologists in the event of a suspicion of a medical condition of an embryo or foetus. In addition, they issue authorisation for preimplantation diagnosis, but also, in particularly serious cases, they can offer parents the possibility of terminating a pregnancy on medical grounds.
The most commonly performed form of prenatal diagnosis is ultrasound imaging. Since 7 July, 2011, this has been regulated by the law of bioethics, on the same basis as prenatal diagnosis carried out biologically on samples whether taken from the foetus and surrounding tissue (amniotic fluid, placental tissue, foetal blood) or the mother’s blood.
THE ROLE OF THE AGENCE DE LA BIOMÉDECINE
The Agence makes its expertise concerning the geographical organisation of the activities of post-natal diagnosis and genetics available to regional health authorities (agencies empowered to authorise institutions to practise these activities). In this capacity, it expresses an opinion on all requests emanating from cytogenetics laboratories, including molecular cytogenetics laboratories, and molecular genetics laboratories wishing to carry out these activities. In conjunction with the regional health authorities, which perform inspections, it also designs control tools (standards, inspection manuals, control questionnaires, etc.) and takes part in the training of these services.
On behalf of the Government, the Agence de la biomédecine has the capacity to authorise activities and have its inspectorate carry out controls of the activities of multidisciplinary centres for prenatal diagnosis and preimplantation genetic diagnosis centres.