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MINISTRY OF
HEALTH
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SOCIALIST
REPUBLIC OF VIET NAM
Independence - Freedom – Happiness
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No. 34/2017/TT-BYT
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Hanoi, August 18,
2017
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CIRCULAR
GUIDELINES FOR PRENATAL
AND NEONATAL CONSULTATION, SCREENING, DIAGNOSIS, AND TREATMENT
Pursuant to Clause 2 Article 97 of the Law on
Marriage and Family dated June 19, 2014;
Pursuant to Clause 2 Article 84 of the Law on
Children dated April 5, 2016;
Pursuant to the Government's Decree No.
75/2017/ND-CP dated June 20, 2017 on functions, tasks, powers and
organizational structure of the Ministry of Health;
At the request of Director of General Office for
Population;
The Minister of Health promulgates a Circular on
guidelines for prenatal and neonatal consultation, screening, diagnosis, and
treatment.
Chapter I
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Article 1. Scope
This Circular sets forth guidelines for prenatal
and neonatal consultation, screening, diagnosis, and treatment.
Article 2. Interpretation of terms
1. Birth defect (also known as congenital
malformation or congenital disorder) refers to an abnormality of the structure
or functions (including abnormality of metabolism) which occurs during the
pregnancy period and may be found before, during, or after birth.
2. Prenatal screening tests refer to a set
of procedures that are performed during pregnancy to determine whether a baby
is likely to have birth defects.
3. Neonatal screening tests refer to a set
of procedures that are performed to determine whether a newborn is likely to
have congenital disorder, pathological signs relating to endocrine
-metabolic-genetic disorder, but not clinically evident in the newborn period.
4. Prenatal diagnosis refers to a set of
procedures that are performed during pregnancy to diagnose whether a baby is
likely to have birth defects that are found through prenatal screening tests.
5. Neonatal diagnosis refers to a set of
specific procedures that are performed during the newborn period to diagnose
whether a newborn is likely to have congenital disorder, pathological signs
relating to endocrine-metabolic-genetic disorder that are found through
neonatal screening tests.
Article 3. Rules for prenatal and neonatal
consultation, screening, diagnosis, and treatment
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2. The prenatal and neonatal consultation,
screening, diagnosis, and treatment will be performed on the voluntary basis.
Particularly, prenatal screening, diagnosis, and treatment are compulsory for
surrogate mothers for humanitarian purpose as prescribed in Clause 2 Article 97
of the Law on marriage and family.
3. The consultation must be performed before,
during, and after prenatal and neonatal screening, diagnosis, and treatment.
Chapter II
PRENATAL AND NEONATAL CONSULTATION, SCREENING,
DIAGNOSIS, AND TREATMENT
Article 4. Prenatal and neonatal screening tests
1. Pre-screening consultation:
A health worker will give a consultation about
prenatal screening tests to a pregnant woman or give a consultation of neonatal
screening tests to a newborn's parents or guardian as follows:
a) Provide purposes, meaning, benefits and possible
risks during performance of screening procedures;
b) Instruct steps of screening procedures to be
performed on a case-by-case basis.
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Health facilities shall perform screening
procedures in accordance with guidelines promulgated by the Minister of Health.
3. Prenatal and post-screening consultation:
A health worker will give a consultation of
prenatal screening tests to a pregnant woman as follows:
a) Inform and explain screening tests’ results;
b) Instruct the pregnant woman to choose methods of
monitoring and caring the unborn baby or further specific diagnosis procedures;
c) Instruct and refer the pregnant woman to another
proper health facility for monitoring and performing diagnosis procedures as
deemed appropriate.
4. Neonatal and post-screening consultation:
The health worker will give a consultation of
neonatal screening tests to the newborn’s parents or guardian as follows:
a) Inform and explain screening tests’ results;
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Article 5. Prenatal and neonatal diagnosis
1. Pre-diagnosis consultation:
A health worker will give a consultation about
prenatal screening tests to a pregnant woman or give a consultation of neonatal
screening tests to a newborn's parents or guardian as follows:
a) Provide purposes, meaning, benefits and possible
risks during performance of diagnosis procedures;
b) Instruct steps of diagnosis procedures to be
performed on a case-by-case basis.
2. Diagnosis:
Health facilities shall perform diagnosis
procedures in accordance with guidelines promulgated by the Minister of Health.
3. Prenatal and diagnosis consultation:
A health worker will give a consultation of
prenatal diagnosis tests to a pregnant woman as follows:
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b) Consult the pregnant woman to choose proper
caring and treatment, including abortion due to birth defects as deemed appropriate.
4. Neonatal and post-diagnosis consultation:
The health worker will give a consultation of
neonatal screening tests to the newborn’s parents or guardian as follows:
a) Provide information about the newborn’s
pathological signs or defects found in the diagnosis; possible consequences if
no timely treatment is performed on a case-by-case basis;
b) Give consultation of newborn monitoring, caring,
and treatment on a case-by-case basis;
c) Instruct the parents or legal guardian to refer
the newborn to another proper health facility for further management,
monitoring, caring and treatment.
Article 6. Prenatal treatment
1. Pre-treatment consultation:
A health worker will give a consultation a pregnant
woman and her husband (if any) as follows:
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b) If the fetus is diagnosed to have defects (with
indication for abortion) and the pregnant woman decides the abortion: possible
risks upon performance of abortion will be consulted;
c) Steps of abortion procedures to be performed on
a case-by-case basis.
2. Treatment:
Health facilities shall perform prenatal treatment
procedures in accordance with guidelines promulgated by the Minister of Health.
3. Regulations on abortion due to birth defects:
a) The abortion will only be considered upon
serious abnormality of form and structure of the fetus; abnormality of
chromosomes, fetus with molecular genetic disorders due to genetic mutations
that no specific therapeutic method is found resulting in high risk of
disability after birth.
b) The abortion due to birth defects will be
considered upon the written consent of the pregnant woman who has received
sufficient consultation from a health worker.
c) A health facility obtaining a property operating
license within its specialities approved by the competent authority must hold a
medical consultation with related specialities to consider whether to abort the
pregnancy.
Medical consultation is composed of specialists
with at least 5 years' experience in the following areas of specialization:
obstetrics, paediatrics, cardiovascular, medical imaging, testing and
pathological anatomy. The medical consultation members may work for departments
in the health facility or are invited from other health facilities.
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Article 7. Neonatal treatment
1. Pre-treatment consultation:
A health worker will give a consultation of
necessity and options of appropriate treatment to the newborn’s parents or
guardian.
2. Treatment:
The health facility shall perform neonatal
monitoring and treatment in accordance with guidelines promulgated by the
Minister of Health on a case-by-case basis.
Chapter III
IMPLEMENTATION
Article 8. Entry in force
This Circular comes into force as of October 2,
2017.
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Article 9. Implementation
Director of General Office for Population; Director
of Department of Pediatric and Maternal Health; Director of Department of
Examination and Treatment Management; heads of units affiliated to the Ministry
of Health; Directors of Departments of Health of provinces and
central-affiliated cities shall implement this Circular.
Difficulties that arise during the implementation
of this Circular should be reported to General Office for Population affiliated
to the Ministry of Health for consideration./.
PP. MINISTER
DEPUTY MINISTER
Nguyen Viet Tien