An Ethical Framework for Research in Maternal-Fetal Intervention in the Presence of Maternal Human Immunodeficiency Virus or Hepatitis B and C Infection

Obstet Gynecol. 2019 Jan;133(1):48-52. doi: 10.1097/AOG.0000000000003022.


Maternal-fetal interventions continue to be a groundbreaking and rapidly expanding area. In this article, we examine whether it is ethically permissible to conduct investigation into the expansion of inclusion criteria for existing maternal-fetal interventions to include pregnant patients with human immunodeficiency virus (HIV) and hepatitis B or C infection with low or undetectable viral loads. We addressed this ethical question by appealing to ethical principle of respect for the autonomy of the pregnant patient; the patient status of the fetus; the balance of overall benefits and risks of the procedure(s) to pregnant, fetal, and neonatal patients; and to the ethical principle of justice. The ethical framework we have provided supports the conclusion that research on maternal-fetal interventions with pregnant women with HIV and hepatitis B and C infection with low or undetectable viral loads is ethically permissible. To accumulate sufficient numbers, such research should be multicenter.

Publication types

  • Editorial

MeSH terms

  • Amniocentesis / ethics
  • Biomedical Research / ethics*
  • Female
  • Fetus*
  • HIV Infections
  • Hepatitis B
  • Hepatitis C
  • Humans
  • Maternal-Child Health Services
  • Pregnancy
  • Pregnancy Complications, Infectious*
  • Prenatal Diagnosis / ethics*
  • United States
  • Virus Diseases*