• Kyodo

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More medical institutions will soon be allowed to conduct blood-based prenatal screenings instead of amniotic fluid tests to detect chromosomal abnormalities such as Down syndrome amid growing demand in a country where more women are delaying pregnancy, a medical group said.

The new type of test, introduced to Japan in 2013, has sparked a bioethics debate because more than 90 percent of women diagnosed with fetus abnormalities have opted for abortion.

The guidelines, set by the Japan Society of Obstetrics and Gynecology, restrict the screenings to designated facilities with counseling services. However, due to growing demand, uncertified medical facilities have started providing the test as well.

The group also limits screenings to pregnant women 35 and older or those with a history of fetal chromosomal abnormalities. Uncertified institutions must carry out the test without such restrictions and claim the ability to distinguish whether the fetus is male or female — a practice that violates the guidelines.

The blame for such practices has been ascribed to the shortage of certified medical institutions with proper counseling services. To remedy this, the group plans to expand the scope of official testing coverage, sources close to the matter said.

At a board meeting in March, the group is expected to discuss the incorporation of prenatal testing in general practice, as well as the easing of screening prerequisites, the sources said.

Since the introduction of prenatal diagnoses, the number of certified facilities conducting the blood-based test nationwide has grown from 15 to 89, and roughly 45,000 people had taken it as of March 2017.

The screening is conducted by taking the mother’s blood at an early stage of pregnancy — after 10 weeks — and analyzing the fetal DNA fragments within to determine whether trisomy 21 (Down syndrome), trisomy 18 (Edwards syndrome) or trisomy 13 (Patau syndrome) are present.

The latter two disorders involve a combination of birth defects. Most babies born with these syndromes die in their first year.

With most women opting for abortion when fetuses test positive for chromosomal abnormalities, there has been criticism that the new screening method is being used too casually by parents-to-be, given its easy access, and that it could end up promoting the concept of eugenics.

One study conducted after the blood-based test was introduced showed that women chose to have abortions due to lack of confidence in giving birth and raising children with chromosomal anomalies, in addition to anxiety about planning for their future.

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