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Fertility and Sterility Aug 2020
Topics: Embryo Implantation; Endometrium; Extracellular Vesicles; Female; Humans; Pregnancy; Reproduction; Surrogate Mothers
PubMed: 32622658
DOI: 10.1016/j.fertnstert.2020.05.007 -
Frontiers in Endocrinology 2021Heterozygous loss-of-function variants of the glucokinase () gene are responsible for a subtype of maturity-onset diabetes of the young (MODY). -MODY is characterized by... (Review)
Review
Heterozygous loss-of-function variants of the glucokinase () gene are responsible for a subtype of maturity-onset diabetes of the young (MODY). -MODY is characterized by a mild hyperglycemia, mainly due to a higher blood glucose threshold for insulin secretion, and an up-regulated glucose counterregulation. -MODY patients are asymptomatic, are not exposed to diabetes long-term complications, and do not require treatment. The diagnosis of -MODY is made on the discovery of hyperglycemia by systematic screening, or by family screening. The situation is peculiar in -MODY women during pregnancy for three reasons: 1. the degree of maternal hyperglycemia is sufficient to induce pregnancy adverse outcomes, as in pregestational or gestational diabetes; 2. the probability that a fetus inherits the maternal mutation is 50% and; 3. fetal insulin secretion is a major stimulus of fetal growth. Consequently, when the fetus has not inherited the maternal mutation, maternal hyperglycemia will trigger increased fetal insulin secretion and growth, with a high risk of macrosomia. By contrast, when the fetus has inherited the maternal mutation, its insulin secretion is set at the same threshold as the mother's, and no fetal growth excess will occur. Thus, treatment of maternal hyperglycemia is necessary only in the former situation, and will lead to a risk of fetal growth restriction in the latter. It has been recommended that the management of diabetes in GCK-MODY pregnant women should be guided by assessment of fetal growth by serial ultrasounds, and institution of insulin therapy when the abdominal circumference is ≥ 75th percentile, considered as a surrogate for the fetal genotype. This strategy has not been validated in women with in GCK-MODY. Recently, the feasibility of non-invasive fetal genotyping has been demonstrated, that will improve the care of these women. Several challenges persist, including the identification of women with -MODY before or early in pregnancy, and the modalities of insulin therapy. Yet, retrospective observational studies have shown that fetal genotype, not maternal treatment with insulin, is the main determinant of fetal growth and of the risk of macrosomia. Thus, further studies are needed to specify the management of -MODY pregnant women during pregnancy.
Topics: Diabetes Mellitus, Type 2; Female; Fetal Development; Fetal Macrosomia; Fetus; Glucokinase; Humans; Hypoglycemic Agents; Insulin; Insulin Secretion; Mutation; Pregnancy; Pregnancy Outcome; Pregnancy in Diabetics
PubMed: 35069449
DOI: 10.3389/fendo.2021.802423 -
Irish Journal of Medical Science Apr 2024Surrogacy is a form of assisted human reproduction whereby a surrogate woman carries a pregnancy for a commissioning couple or individual. There are two types of... (Review)
Review
BACKGROUND
Surrogacy is a form of assisted human reproduction whereby a surrogate woman carries a pregnancy for a commissioning couple or individual. There are two types of surrogacy, traditional and gestational. Worldwide we have seen a rapid increase in the use of surrogacy. Despite this, there is a lack of consensus internationally on the laws governing surrogacy. In Ireland, surrogacy remains largely unregulated. Currently, there is no specific legislation for surrogacy. This review aims to discuss its current regulatory status and associated ethical issues.
AIMS
On surrogacy from an Irish legal perspective, this study is to (i) demonstrate the lack of legislation, (ii) describe the Health Bill 2022 and (iii) examine the challenges surrounding surrogacy and Irish case law. On surrogacy from an Irish ethical perspective, this study is to (iv) discuss the ethical issues surrounding autonomy, (v) discuss the ethical issues surrounding non-maleficence, (vi) discuss the ethical issues surrounding justice and (vii) evaluate ethical issues specific to commercial surrogacy: (1) child welfare and (2) commodification and exploitation of children and women's bodies.
CONCLUSION
Surrogacy has raised several ethical issues. There are issues surrounding autonomy of the surrogate and commissioning couple, child welfare, exploitation and commodification, non-maleficence and justice. There are also significant legal concerns with surrogacy. It is neither legal nor illegal in Ireland. This creates challenges for the commissioning couple particularly in terms of custody of the child.
Topics: Pregnancy; Child; Female; Humans; Ireland; Surrogate Mothers; Uterus
PubMed: 37831359
DOI: 10.1007/s11845-023-03546-9 -
Cambridge Quarterly of Healthcare... Jan 2024A number of countries and states prohibit surrogacy except in cases of "medical necessity" or for those with specific medical conditions. Healthcare providers in some...
A number of countries and states prohibit surrogacy except in cases of "medical necessity" or for those with specific medical conditions. Healthcare providers in some countries have similar policies restricting the provision of clinical assistance in surrogacy. This paper argues that surrogacy is never medically necessary in any ordinary understanding of this term. The author aims to show first that surrogacy per se is a socio-legal intervention and not a medical one and, second, that the intervention in question does not treat, prevent, or mitigate any actual or potential harm to health. Legal regulations and healthcare-provider policies of this kind therefore codify a fiction-one which both obscures the socio-legal motivations for surrogacy and inhibits critical examination of those motivations while mobilizing normative connotations of appeals to medical need. The persisting distinction, in law and in moral discourse, between "social" and "medical" surrogacy, is unjustified.
Topics: Female; Pregnancy; Humans; Surrogate Mothers; Morals
PubMed: 37170395
DOI: 10.1017/S0963180123000269 -
Journal of Advanced Nursing Apr 2024To describe the current state of the literature on nurses' and midwives' knowledge, perceptions and experiences of managing parental postnatal depression (PPND). (Review)
Review
AIM
To describe the current state of the literature on nurses' and midwives' knowledge, perceptions and experiences of managing parental postnatal depression (PPND).
DESIGN
The Joanna Briggs Institute scoping review method and the PRISMA extension for Scoping Reviews guided the work.
DATA SOURCES
A systematic search of PubMed, CINAHL, Embase, MEDLINE, PsycINFO and Scopus databases was conducted in January and February 2023.
REVIEW METHODS
Peer-reviewed primary research articles published in English between 2012 and 2023 that involved nurses or midwives managing PPND were included. Rayyan was used to screen titles, abstracts and full-text articles. A spreadsheet was used to organize extracted data and synthesize results.
RESULTS
Twenty-nine articles met the inclusion criteria. Most study samples were of mothers, and few were from middle- and lower-income countries. Nurses and midwives lacked knowledge about PPND, yet they felt responsible for its management. Nurses and midwives faced significant organizational and systems-level challenges in managing PPND. However, nurses and midwives facilitated PPND care in collaboration with other healthcare providers.
CONCLUSION
The review highlights significant gaps in the nurses' and midwives' care of PPND. Educational programmes are necessary to increase nurse and midwife knowledge of PPND and strategies for its management, including facilitating collaboration across the healthcare system and eliminating organizational and systemic-related barriers. Additional focused research is needed on nurses' and midwives' knowledge, perception of and experience with PPND beyond mothers, such as with fathers, sexually and gender-minoritized parents and surrogate mothers. Finally, additional research is needed in middle- and lower-income countries where nurses and midwives may face a higher burden of and unique cultural considerations in managing PPND.
IMPACT
PPND can affect the parent's mental and physical health and relationship with their child. If left untreated, PPND can lead to long-term consequences, including child developmental delays, behavioural problems and difficulties with parental-child attachment.
REPORTING METHOD
This scoping review adheres to PRISMA Extension for Scoping Review guidelines and the Joanna Briggs Institute scoping review method.
PATIENT OR PUBLIC CONTRIBUTION
This research is a scoping review of published peer-reviewed studies.
PubMed: 38558297
DOI: 10.1111/jan.16186 -
Health and Human Rights Dec 2023Surrogacy operates in a regulatory void in Argentina. Despite attempts to legislate this practice, Argentine law contains no univocal rules governing the legality and... (Review)
Review
Surrogacy operates in a regulatory void in Argentina. Despite attempts to legislate this practice, Argentine law contains no univocal rules governing the legality and enforceability of surrogacy agreements. Unsurprisingly, this has not stopped intended parents from pursuing surrogacy; quite the contrary, it has steered them into the courts, thrusting the issue into the realm of judicial policy. Through a comprehensive review and qualitative study of 32 court rulings, I address the judicial scenario regarding surrogacy in Argentina. I describe the profile of litigants who are bringing altruistic gestational surrogacy claims, the legal arguments used by courts, and the types of orders issued. I explain how the judiciary, through judicial review of the current legal framework and the application of international human rights law, including the principle of the best interests of the child, is playing a key role in ensuring access to this form of third-party assisted reproductive technology. Finally, I make the case for regulation by critically assessing these rulings to highlight the intricacies, challenges, and complexities that come with the judicial regulation of surrogacy.
Topics: Female; Pregnancy; Child; Humans; Human Rights; Surrogate Mothers; Argentina; Reproductive Techniques, Assisted; Law Enforcement
PubMed: 38145139
DOI: No ID Found -
Cureus Apr 2023With the advent of major scientific and technological advancements in obstetrics and gynecology, surrogacy is quickly becoming a viable alternative to enable people of... (Review)
Review
With the advent of major scientific and technological advancements in obstetrics and gynecology, surrogacy is quickly becoming a viable alternative to enable people of all genders to become parents. However, its path toward reality is still fraught with legal and ethical dilemmas. With the Surrogacy Act of 2021 coming into effect earlier this year, the present article aims to dissect the various legal nuances involved while also considering the societal norms governing the actual scenario at ground zero. Our review discusses the aspects of eligibility criteria, the health implications, the rights of the surrogate mother and the child born, the financial burden, and compensation. We aimed to bring attention to this act and its implications on marginalized segments of society, with an attempt to bring beneficial changes for them. In this review, we provide viable alternatives adopted across the globe to solve the identified issues to make the present act non-discriminatory and more rewarding to all involved beneficiaries.
PubMed: 37213977
DOI: 10.7759/cureus.37864 -
Fertility and Sterility May 2022Cross-border reproductive care is a growing worldwide phenomenon, raising questions about why assisted reproductive technology patients travel for care, what harms and...
Cross-border reproductive care is a growing worldwide phenomenon, raising questions about why assisted reproductive technology patients travel for care, what harms and benefits may result, and what duties health care providers may have in advising and treating the patients who travel for reproductive services. Cross-border care may benefit or harm assisted reproductive technology stakeholders, including patients, offspring, providers, gamete donors, gestational carriers, and local populations in destination countries. This document replaces the previous document of the same name, last published in 2016.
Topics: Ethics Committees; Female; Health Personnel; Humans; Medical Tourism; Pregnancy; Reproductive Techniques, Assisted; Surrogate Mothers
PubMed: 35216836
DOI: 10.1016/j.fertnstert.2022.01.012 -
Animals : An Open Access Journal From... Mar 2021Orangutans depend on social learning for the acquisition of survival skills. The development of skills is not usually assessed in rescued orphans' pre-release. We...
Orangutans depend on social learning for the acquisition of survival skills. The development of skills is not usually assessed in rescued orphans' pre-release. We collected data of seven orphans over an 18-months-period to monitor the progress of ontogenetic changes. The orphans, 1.5-9 years old, were immersed in a natural forest environment with human surrogate mothers and other orphans. Social interactions deviated significantly from those of wild mother-reared immatures. Infants spent more time playing socially with peers, at the expense of resting and solitary play. Infants were also more often and at an earlier age distant from their human surrogate mothers than wild immatures are from their biological mothers. We found important changes towards an orangutan-typical lifestyle in 4- to 7-year-old orphans, corresponding to the weaning age in maternally reared immatures. The older orphans spent less time interacting with human surrogate mothers or peers, started to use the canopy more than lower forest strata and began to sleep in nests in the forest. Their time budgets resembled those of wild adults. In conclusion, juvenile orphans can develop capacities that qualify them as candidates for release back into natural habitat when protected from humanising influences and immersed in a species-typical environment.
PubMed: 33802019
DOI: 10.3390/ani11030767 -
Harefuah Jan 2020During July 2018, Israel went through a social turmoil due to the completion of the legislation of the surrogacy act which exclude gay men from the option of having... (Review)
Review
During July 2018, Israel went through a social turmoil due to the completion of the legislation of the surrogacy act which exclude gay men from the option of having their own children through surrogate pregnancy. Gay men were outraged also because this denial of the state means that such treatment will not be subsidize since these treatments are quite expensive. In light of the public and media mayhem following the above mentioned law, we revise the relevant literature regarding surrogate pregnancies, mainly for the social aspect of this issue. It seems that most women, who experience surrogate pregnancy, are not affected physically or mentally. However, these finding may not be relevant to surrogate women in underdeveloped countries who, sometimes, are doing it for the financial benefit. More specifically, this review deals with the new Israeli legislation, which incorporates in it religious elements, hence it prevents certain populations (such as gay men) from the only feasible possibility to become fathers. We emphasize that we describe the situation as it is presented in the current literature as spectators but not as judges.
Topics: Child; Fathers; Female; Humans; Israel; Male; Pregnancy; Surrogate Mothers
PubMed: 31930809
DOI: No ID Found