<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0123-3122</journal-id>
<journal-title><![CDATA[Persona y Bioética]]></journal-title>
<abbrev-journal-title><![CDATA[pers.bioét.]]></abbrev-journal-title>
<issn>0123-3122</issn>
<publisher>
<publisher-name><![CDATA[Universidad de la Sabana]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0123-31222022000200005</article-id>
<article-id pub-id-type="doi">10.5294/pebi.2022.26.2.6</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Conducta médica frente al diagnóstico prenatal de trisomía 18: ¿se aproxima un cambio de paradigma?]]></article-title>
<article-title xml:lang="en"><![CDATA[Medical Conduct Regarding the Prenatal Diagnosis of Trisomy 18: Is a Paradigm Shift Coming Soon?]]></article-title>
<article-title xml:lang="pt"><![CDATA[Conduta médica ante o diagnóstico pré-natal de trissomia 18: uma mudança de paradigma se aproxima?]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Grimaux]]></surname>
<given-names><![CDATA[Guadalupe]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Páez]]></surname>
<given-names><![CDATA[Gustavo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Austral  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Argentina</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Austral  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Argentina</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2022</year>
</pub-date>
<volume>26</volume>
<numero>2</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S0123-31222022000200005&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S0123-31222022000200005&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S0123-31222022000200005&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen El objetivo del trabajo es analizar dos conductas médicas opuestas en la vida prenatal de los niños con trisomía 18: el aborto y los cuidados paliativos perinatales. Se realizó una búsqueda bibliográfica en PubMed a partir de los términos &#8220;trisomy 18&#8221;, &#8220;abortion&#8221; y &#8220;palliative care&#8221;. Actualmente, están cambiando las conductas médicas dirigidas a los niños nacidos con trisomía 18, debido a que ya no se la considera una enfermedad incompatible con la vida. Este cambio de paradigma en la conducta médica posnatal debería reflejarse en la conducta prenatal, para ofrecer a los padres alternativas distintas al aborto. Los cuidados paliativos fetales y perinatales constituyen una respuesta ética válida para el tratamiento de niños con trisomía 18.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract This article intends to analyze two opposing medical behaviors in the prenatal life of children with trisomy 18: abortion and perinatal palliative care. A literature search was carried out in PubMed using the terms &#8220;trisomy 18,&#8221; &#8220;abortion,&#8221; and &#8220;palliative care.&#8221; Medical behaviors toward children born with trisomy 18 are changing because it is no longer considered a disease incompatible with life. This paradigm shift in postnatal medical conduct should be reflected in prenatal behavior to offer parents alternatives to abortion. Fetal and perinatal palliative care is a valid ethical response for treating children with trisomy 18.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo O objetivo deste trabalho é analisar duas condutas médicas opostas na vida pré-natal das crianças com trissomia 18: o aborto e os cuidados paliativos perinatais. Foi realizada uma busca bibliográfica no PubMed a partir dos termos &#8220;trisomy 18&#8221;, &#8220;abortion&#8221; e &#8220;palliative care&#8221;. Atualmente, as condutas médicas para com as crianças nascidas com trissomia 18 estão mudando devido a não ser considerada mais como uma doença incompatível com a vida. Essa mudança de paradigma na conduta médica pós-natal deveria ser refletida na conduta pré-natal, para oferecer aos pais alternativas diferentes do aborto. Os cuidados paliativos fetais e perinatais constituem uma resposta ética válida para tratar crianças com trissomia 18.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[síndrome de Edwards]]></kwd>
<kwd lng="es"><![CDATA[trisomía]]></kwd>
<kwd lng="es"><![CDATA[aborto]]></kwd>
<kwd lng="es"><![CDATA[cuidados paliativos]]></kwd>
<kwd lng="es"><![CDATA[diagnóstico prenatal]]></kwd>
<kwd lng="es"><![CDATA[bioética]]></kwd>
<kwd lng="es"><![CDATA[ética]]></kwd>
<kwd lng="en"><![CDATA[Trisomy 18 syndrome]]></kwd>
<kwd lng="en"><![CDATA[trisomy]]></kwd>
<kwd lng="en"><![CDATA[abortion]]></kwd>
<kwd lng="en"><![CDATA[palliative care]]></kwd>
<kwd lng="en"><![CDATA[prenatal diagnosis]]></kwd>
<kwd lng="en"><![CDATA[bioethics]]></kwd>
<kwd lng="en"><![CDATA[ethics]]></kwd>
<kwd lng="pt"><![CDATA[síndrome de Edwards]]></kwd>
<kwd lng="pt"><![CDATA[trissomia]]></kwd>
<kwd lng="pt"><![CDATA[aborto]]></kwd>
<kwd lng="pt"><![CDATA[cuidados paliativos]]></kwd>
<kwd lng="pt"><![CDATA[diagnóstico pré-natal]]></kwd>
<kwd lng="pt"><![CDATA[bioética]]></kwd>
<kwd lng="pt"><![CDATA[ética]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mullin]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Wolfe]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Bluebond-Langner]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Craig]]></surname>
<given-names><![CDATA[F.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Experiences of children with trisomy 18 referred to pediatric palliative care services on two continents.]]></article-title>
<source><![CDATA[Am J Med Genet A.]]></source>
<year>2019</year>
<volume>179</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>903-7</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hurley]]></surname>
<given-names><![CDATA[EH]]></given-names>
</name>
<name>
<surname><![CDATA[Krishnan]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Parton]]></surname>
<given-names><![CDATA[LA]]></given-names>
</name>
<name>
<surname><![CDATA[Dozor]]></surname>
<given-names><![CDATA[AJ.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Differences in perspective on prognosis and treatment of children with trisomy 18]]></article-title>
<source><![CDATA[Am J Med Genet A.]]></source>
<year>2014</year>
<volume>164A</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>2551-6</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cereda]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Carey]]></surname>
<given-names><![CDATA[JC.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The trisomy 18]]></article-title>
<source><![CDATA[Orphanet J Rare Dis]]></source>
<year>2012</year>
<numero>7</numero>
<issue>7</issue>
<page-range>81</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nelson]]></surname>
<given-names><![CDATA[KE]]></given-names>
</name>
<name>
<surname><![CDATA[Hexem]]></surname>
<given-names><![CDATA[KR]]></given-names>
</name>
<name>
<surname><![CDATA[Feudtner]]></surname>
<given-names><![CDATA[C.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Inpatient hospital care of children with trisomy 13 and trisomy 18 in the United States]]></article-title>
<source><![CDATA[Pediatrics]]></source>
<year>2012</year>
<volume>129</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>869-76</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Edwards]]></surname>
<given-names><![CDATA[JH]]></given-names>
</name>
<name>
<surname><![CDATA[Harnden]]></surname>
<given-names><![CDATA[DG]]></given-names>
</name>
<name>
<surname><![CDATA[Cameron]]></surname>
<given-names><![CDATA[AH]]></given-names>
</name>
<name>
<surname><![CDATA[Crosse]]></surname>
<given-names><![CDATA[VM]]></given-names>
</name>
<name>
<surname><![CDATA[Wolff]]></surname>
<given-names><![CDATA[OH.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A new trisomic syndrome]]></article-title>
<source><![CDATA[Lancet]]></source>
<year>1960</year>
<volume>1</volume>
<numero>7128</numero>
<issue>7128</issue>
<page-range>787-90</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Thorvilson]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Copeland]]></surname>
<given-names><![CDATA[AJ.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Incompatible with care: examining trisomy 18 medical discourse and families&#8217; counter-discourse for recuperative ethos.]]></article-title>
<source><![CDATA[J Med Humanit.]]></source>
<year>2017</year>
<volume>39</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>349-60</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Meyer]]></surname>
<given-names><![CDATA[RE]]></given-names>
</name>
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Gilboa]]></surname>
<given-names><![CDATA[SM]]></given-names>
</name>
<name>
<surname><![CDATA[Ethen]]></surname>
<given-names><![CDATA[MK]]></given-names>
</name>
<name>
<surname><![CDATA[Aylsworth]]></surname>
<given-names><![CDATA[AS]]></given-names>
</name>
<name>
<surname><![CDATA[Powell]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[National birth defects prevention network. Survival of children with trisomy 13 and trisomy 18: a multi-state population-based study.]]></article-title>
<source><![CDATA[Am J Med Genet A.]]></source>
<year>2016</year>
<volume>170A</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>825-37</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Patterson]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Taylor]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Smith]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Dotters-Katz]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Davis]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Price]]></surname>
<given-names><![CDATA[W.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Transitions in care for infants with trisomy 13 or 18]]></article-title>
<source><![CDATA[Am J Perinatol]]></source>
<year>2017</year>
<volume>34</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>887-94</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jacobs]]></surname>
<given-names><![CDATA[AP]]></given-names>
</name>
<name>
<surname><![CDATA[Subramaniam]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Tang]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[3rd]]></surname>
<given-names><![CDATA[Philips JB]]></given-names>
</name>
<name>
<surname><![CDATA[Biggio]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
<name>
<surname><![CDATA[Edwards]]></surname>
<given-names><![CDATA[RK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Trisomy 18: a survey of opinions, attitudes, and practices of neonatologists.]]></article-title>
<source><![CDATA[Am J Med Genet A.]]></source>
<year>2016</year>
<volume>170</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>2638-43</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wilkinson]]></surname>
<given-names><![CDATA[DJC]]></given-names>
</name>
<name>
<surname><![CDATA[De Crespigny]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Lees]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Savulescu]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Thiele]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Tran]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Perinatal management of trisomy 18: a survey of obstetricians in Australia, New Zealand and the UK.]]></article-title>
<source><![CDATA[Prenatal Diagn.]]></source>
<year>2014</year>
<volume>34</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>42-9</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yates]]></surname>
<given-names><![CDATA[AR]]></given-names>
</name>
<name>
<surname><![CDATA[Hoffman]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Shepherd]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Boettner]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Mcbride]]></surname>
<given-names><![CDATA[K.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pediatric sub-specialist controversies in the treatment of congenital heart disease in trisomy 13 or 18.]]></article-title>
<source><![CDATA[J Genet Couns.]]></source>
<year>2011</year>
<volume>20</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>495-509</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kaulfus]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
<name>
<surname><![CDATA[Gardiner]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Hashmi]]></surname>
<given-names><![CDATA[SS]]></given-names>
</name>
<name>
<surname><![CDATA[Mendez-Figueroa]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Miller]]></surname>
<given-names><![CDATA[VJ]]></given-names>
</name>
<name>
<surname><![CDATA[Stevens]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Attitudes of clinicians towards surgery and trisomy 18.]]></article-title>
<source><![CDATA[J Genet Couns.]]></source>
<year>2019</year>
<volume>28</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>654-63</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Goc]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Walencka]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[W&#322;och]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Wojciechowska]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Wiecek-W&#322;odarska]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Krzystolik-&#321;adzi&#324;ska]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Trisomy 18 in neonates: prenatal diagnosis, clinical features, therapeutic dilemmas and outcome.]]></article-title>
<source><![CDATA[J Appl Genet.]]></source>
<year>2006</year>
<volume>47</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>165-70</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nguyen]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
<name>
<surname><![CDATA[Salemi]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
<name>
<surname><![CDATA[Tanner]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
<name>
<surname><![CDATA[Kirby]]></surname>
<given-names><![CDATA[RS]]></given-names>
</name>
<name>
<surname><![CDATA[Sutsko]]></surname>
<given-names><![CDATA[RP]]></given-names>
</name>
<name>
<surname><![CDATA[Ashmeade]]></surname>
<given-names><![CDATA[TL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Survival and healthcare utilization of infants diagnosed with lethal congenital malformations.]]></article-title>
<source><![CDATA[J Perinatol.]]></source>
<year>2018</year>
<volume>38</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>1674-84</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nishiyama]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Sekizawa]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Ogawa]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Sawai]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Nakamura]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Samura]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Factors affecting parental decisions to termite pregnancy in the presence of chromosome abnormalities: a Japanese multicenter study.]]></article-title>
<source><![CDATA[Prenat Diagn]]></source>
<year>2016</year>
<volume>36</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>1121-6</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dobson]]></surname>
<given-names><![CDATA[LJ]]></given-names>
</name>
<name>
<surname><![CDATA[Reiff]]></surname>
<given-names><![CDATA[ES]]></given-names>
</name>
<name>
<surname><![CDATA[Little]]></surname>
<given-names><![CDATA[SE]]></given-names>
</name>
<name>
<surname><![CDATA[Wilkins-Haug]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Bromley]]></surname>
<given-names><![CDATA[B.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Patient choice and clinical outcomes following positive noninvasive prenatal screening for aneuploidy with cell-free DNA (cfDNA)]]></article-title>
<source><![CDATA[Prenat Diagn.]]></source>
<year>2016</year>
<volume>36</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>456-62</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hume]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Chasen]]></surname>
<given-names><![CDATA[ST.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Trends in timing of prenatal diagnosis and abortion for fetal chromosomal abnormalities]]></article-title>
<source><![CDATA[Am J Obstet Gynecol.]]></source>
<year>2015</year>
<volume>213</volume>
<numero>4</numero>
<issue>4</issue>
</nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Silberberg]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Robetto]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Grimaux]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Nucifora]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Moreno Villares]]></surname>
<given-names><![CDATA[JM.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Ethical issues about the paradigm shift in the treatment of children with trisomy 18]]></article-title>
<source><![CDATA[Eur J Pediatr.]]></source>
<year>2020</year>
<volume>179</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>493-7</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gekas]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Langlois]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Ravitsky]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Audibert]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Van den Berg]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Haidar]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Identification of trisomy 18, trisomy 13, and Down syndrome from maternal plasma.]]></article-title>
<source><![CDATA[Appl Clin Genet]]></source>
<year>2014</year>
<numero>7</numero>
<issue>7</issue>
<page-range>127-31</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Etchegaray]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Palma]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[De Rosa]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Russo]]></surname>
<given-names><![CDATA[RD]]></given-names>
</name>
<name>
<surname><![CDATA[Beruti]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Fregonese]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cirugía fetal de mielomeningocele: evolución obstétrica y resultados perinatales a corto plazo de una cohorte de 21 casos.]]></article-title>
<source><![CDATA[Surg Neurol Int]]></source>
<year>2018</year>
<volume>9</volume>
<numero>^s4</numero>
<issue>^s4</issue>
<supplement>4</supplement>
<page-range>S73-4</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Otayza]]></surname>
<given-names><![CDATA[F.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cirugía fetal del mielomeningocele fetal]]></article-title>
<source><![CDATA[Rev Med Clin Condes]]></source>
<year>2015</year>
<volume>26</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>442-51</page-range></nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[De Mézerac]]></surname>
<given-names><![CDATA[I.]]></given-names>
</name>
</person-group>
<source><![CDATA[Un hijo para la eternidad]]></source>
<year>2004</year>
<publisher-loc><![CDATA[Madrid ]]></publisher-loc>
<publisher-name><![CDATA[Rialp]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B23">
<label>23</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rodríguez Martín]]></surname>
<given-names><![CDATA[E.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[La extensión de la eugenesia en el ámbito sanitario español a través del diagnóstico prenatal]]></article-title>
<source><![CDATA[Cuad Bioét]]></source>
<year>2012</year>
<numero>23</numero>
<issue>23</issue>
<page-range>53-70</page-range></nlm-citation>
</ref>
<ref id="B24">
<label>24</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Marc-Aurele]]></surname>
<given-names><![CDATA[KL]]></given-names>
</name>
<name>
<surname><![CDATA[Nelesen]]></surname>
<given-names><![CDATA[R.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A five-year review of referrals for perinatal palliative care]]></article-title>
<source><![CDATA[J Palliat Med.]]></source>
<year>2013</year>
<volume>16</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>1232-6</page-range></nlm-citation>
</ref>
<ref id="B25">
<label>25</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Janvier]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Farlow]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Barrington]]></surname>
<given-names><![CDATA[KJ.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Parental hopes, interventions, and survival of neonates with trisomy 13 and trisomy 18]]></article-title>
<source><![CDATA[Am J Med Genet C Semin Med Genet.]]></source>
<year>2016</year>
<volume>172</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>279-87</page-range></nlm-citation>
</ref>
<ref id="B26">
<label>26</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Marc-Aurele]]></surname>
<given-names><![CDATA[KL]]></given-names>
</name>
<name>
<surname><![CDATA[Hull]]></surname>
<given-names><![CDATA[AD]]></given-names>
</name>
<name>
<surname><![CDATA[Jones]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
<name>
<surname><![CDATA[Pretorius]]></surname>
<given-names><![CDATA[DH.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A fetal diagnostic center&#8217;s referral rate for perinatal palliative care]]></article-title>
<source><![CDATA[Ann Palliat Med.]]></source>
<year>2018</year>
<volume>7</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>177-85</page-range></nlm-citation>
</ref>
<ref id="B27">
<label>27</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Aiyer]]></surname>
<given-names><![CDATA[AN]]></given-names>
</name>
<name>
<surname><![CDATA[Ruiz]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Steinman]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Ho]]></surname>
<given-names><![CDATA[GY.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Influence of physician attitudes on willingness to perform abortion]]></article-title>
<source><![CDATA[Obstet Gynecol]]></source>
<year>1999</year>
<numero>93</numero>
<issue>93</issue>
<page-range>576-80</page-range></nlm-citation>
</ref>
<ref id="B28">
<label>28</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Janvier]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Farlow]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Barrington]]></surname>
<given-names><![CDATA[KJ]]></given-names>
</name>
<name>
<surname><![CDATA[Bourque]]></surname>
<given-names><![CDATA[CJ]]></given-names>
</name>
<name>
<surname><![CDATA[Brazq]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Wilfond]]></surname>
<given-names><![CDATA[B.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Building trust and improving communication with parents of children with trisomy 13 and 18: a mixed-methods study.]]></article-title>
<source><![CDATA[Palliat Med]]></source>
<year>2020</year>
<volume>34</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>262-71</page-range></nlm-citation>
</ref>
<ref id="B29">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hasegawa]]></surname>
<given-names><![CDATA[SL]]></given-names>
</name>
<name>
<surname><![CDATA[Fry]]></surname>
<given-names><![CDATA[JT]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Moving toward a shared process: the impact of parent experiences on perinatal palliative care]]></article-title>
<source><![CDATA[Semin Perinatol]]></source>
<year>2017</year>
<volume>41</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>95-100</page-range></nlm-citation>
</ref>
<ref id="B30">
<label>30</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Janvier]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Farlow]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Barrington]]></surname>
<given-names><![CDATA[K.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cardiac surgery for children with trisomies 13 and 18: Where are we now?]]></article-title>
<source><![CDATA[Semin Perinatol]]></source>
<year>2016</year>
<volume>40</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>254-60</page-range></nlm-citation>
</ref>
<ref id="B31">
<label>31</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dotters-Katz]]></surname>
<given-names><![CDATA[SK]]></given-names>
</name>
<name>
<surname><![CDATA[Kuller]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Grace]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
<name>
<surname><![CDATA[Laifer]]></surname>
<given-names><![CDATA[SA]]></given-names>
</name>
<name>
<surname><![CDATA[Strauss]]></surname>
<given-names><![CDATA[RA.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Management considerations for ongoing pregnancies complicated by trisomy 13 and 18]]></article-title>
<source><![CDATA[Obstet Gynecol Surv]]></source>
<year>2016</year>
<volume>71</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>295-300</page-range></nlm-citation>
</ref>
<ref id="B32">
<label>32</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Carey]]></surname>
<given-names><![CDATA[JC.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Attitudes of neonatologists toward delivery room management of confirmed trisomy 18: potential factors influencing a changing dynamic.]]></article-title>
<source><![CDATA[Pediatrics]]></source>
<year>2009</year>
<volume>123</volume>
<numero>3</numero>
<issue>3</issue>
</nlm-citation>
</ref>
<ref id="B33">
<label>33</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Venneman]]></surname>
<given-names><![CDATA[SS]]></given-names>
</name>
<name>
<surname><![CDATA[Narnor-Harris]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Perish]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Hamilton]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[&#8220;Allow natural death&#8221; versus &#8220;do not resuscitate&#8221;: three words that can change a life]]></article-title>
<source><![CDATA[J Med Ethics]]></source>
<year>2008</year>
<volume>34</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>2-6</page-range></nlm-citation>
</ref>
<ref id="B34">
<label>34</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Koogler]]></surname>
<given-names><![CDATA[TK]]></given-names>
</name>
<name>
<surname><![CDATA[Wilfond]]></surname>
<given-names><![CDATA[BS]]></given-names>
</name>
<name>
<surname><![CDATA[Friedman Ross]]></surname>
<given-names><![CDATA[L.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Lethal language, lethal decisions]]></article-title>
<source><![CDATA[Hastings Cent Rep]]></source>
<year>2003</year>
<volume>33</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>37-41</page-range></nlm-citation>
</ref>
<ref id="B35">
<label>35</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wilkinson]]></surname>
<given-names><![CDATA[DJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Antenatal diagnosis of trisomy 18, harm and parental choice]]></article-title>
<source><![CDATA[J Med Ethics]]></source>
<year>2010</year>
<volume>36</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>644-5</page-range></nlm-citation>
</ref>
<ref id="B36">
<label>36</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cerruti]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Terapie fetali: questioni etiche]]></article-title>
<source><![CDATA[Medicina e Morale]]></source>
<year>2016</year>
<numero>4</numero>
<issue>4</issue>
<page-range>403-32</page-range></nlm-citation>
</ref>
<ref id="B37">
<label>37</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Duque]]></surname>
<given-names><![CDATA[JAP]]></given-names>
</name>
<name>
<surname><![CDATA[Ferreira]]></surname>
<given-names><![CDATA[CF]]></given-names>
</name>
<name>
<surname><![CDATA[Zachia]]></surname>
<given-names><![CDATA[SA]]></given-names>
</name>
<name>
<surname><![CDATA[Sanseverino]]></surname>
<given-names><![CDATA[MTV]]></given-names>
</name>
<name>
<surname><![CDATA[Gus]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Magalhães]]></surname>
<given-names><![CDATA[JAA.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The natural history of pregnancies with prenatal diagnosis of trisomy 18 or trisomy 13: retrospective casos of a 23-year experience in a Brazilian public hospital.]]></article-title>
<source><![CDATA[Genet Mol Biol.]]></source>
<year>2019</year>
<volume>42</volume>
<numero>^s1</numero>
<issue>^s1</issue>
<supplement>1</supplement>
<page-range>286-96</page-range></nlm-citation>
</ref>
<ref id="B38">
<label>38</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sgreccia]]></surname>
<given-names><![CDATA[E.]]></given-names>
</name>
</person-group>
<source><![CDATA[Manual de Bioética. Fundamentos y ética biomédica]]></source>
<year>2015</year>
<publisher-loc><![CDATA[Madrid ]]></publisher-loc>
<publisher-name><![CDATA[Biblioteca autores cristianos]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B39">
<label>39</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Monfort Prades]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Marías]]></surname>
<given-names><![CDATA[Julián]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Una respuesta responsable al problema del aborto]]></article-title>
<source><![CDATA[Cuad Bioét.]]></source>
<year>2010</year>
<numero>21</numero>
<issue>21</issue>
<page-range>341-54</page-range></nlm-citation>
</ref>
<ref id="B40">
<label>40</label><nlm-citation citation-type="">
<source><![CDATA[]]></source>
<year></year>
<numero>22</numero>
<issue>22</issue>
<page-range>283-308</page-range></nlm-citation>
</ref>
<ref id="B41">
<label>41</label><nlm-citation citation-type="">
<collab>Asamblea General de la ONU</collab>
<source><![CDATA[Declaración Universal de los Derechos Humanos (217 (III) A)]]></source>
<year>1948</year>
</nlm-citation>
</ref>
<ref id="B42">
<label>42</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pardo Vargas]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
<name>
<surname><![CDATA[Aracena]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Cares]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Cortés]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Daundes]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Mellado]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Congenital anomalies of poor prognosis. Genetic consensus committee]]></article-title>
<source><![CDATA[Rev Chil Pediatr.]]></source>
<year>2016</year>
<volume>87</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>422-31</page-range></nlm-citation>
</ref>
<ref id="B43">
<label>43</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[De Martini]]></surname>
<given-names><![CDATA[S.]]></given-names>
</name>
</person-group>
<source><![CDATA[El médico frente al aborto]]></source>
<year>2012</year>
<publisher-loc><![CDATA[Buenos Aires ]]></publisher-loc>
<publisher-name><![CDATA[Educa]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B44">
<label>44</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Spaemann]]></surname>
<given-names><![CDATA[R.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tema de estudio: el comienzo de la vida humana, filosofía y biología]]></article-title>
<source><![CDATA[Cuad Bioét]]></source>
<year>1997</year>
<page-range>1027-33</page-range></nlm-citation>
</ref>
<ref id="B45">
<label>45</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pravin]]></surname>
<given-names><![CDATA[RR.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Modern marvels of children&#8217;s palliative care]]></article-title>
<source><![CDATA[J Palliat Med]]></source>
<year>2015</year>
<volume>18</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>1078-9</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
