Perinatal palliative care (PPC) is an option for patients who discover that their infant has a life-limiting fetal condition, which decreases the burden of the condition using a multidisciplinary approach.
Study Design
This review discusses the landmark literature in the past two decades, which have seen significant growth and development in the concept of PPC.
Results
The literature describes the background, quality, and benefits of offering PPC, as well as the ethical principles that support its being offered in every discussion of fetal life-limiting diagnoses.
Conclusion
PPC shares a similar risk profile to other options after life-limiting diagnosis, including satisfaction with choice of continuation of pregnancy. The present clinical opinion closes by noting common barriers to establishing PPC programs and offers a response to overcome each one. KEY POINTS: · Perinatal palliative care serves patients who continue pregnancies with life-limiting fetal anomaly.. · Perinatal palliative care has a risk profile similar to other options such as termination.. · Health care providers can serve as champions to extend PPC to patients in their region..
perinatal palliative care life-limiting fetal diagnosis scoping review, perinatal palliative care continuation pregnancy outcomes, Buskmiller Calhoun perinatal palliative care review, life-limiting fetal anomaly management options parents, perinatal palliative care program barriers implementation, fetal diagnosis lethal anomaly palliative care versus termination, perinatal hospice multidisciplinary approach fetal condition, patient satisfaction perinatal palliative care pregnancy continuation, ethical principles offering perinatal palliative care, perinatal palliative care risk profile compared termination
PMID 34856607 34856607 DOI 10.1055/s-0041-1740251 10.1055/s-0041-1740251
Cite this article
Cara Buskmiller, & Calhoun, B. C. (2023). A Scoping Review of Perinatal Palliative Care: Allowing Parents to Be Parents. American journal of perinatology, 40(12), 1373-1377. https://doi.org/10.1055/s-0041-1740251
Cara Buskmiller, Calhoun BC. A Scoping Review of Perinatal Palliative Care: Allowing Parents to Be Parents. Am J Perinatol. 2023;40(12):1373-1377. doi:10.1055/s-0041-1740251
Cara Buskmiller, and B. C. Calhoun. "A Scoping Review of Perinatal Palliative Care: Allowing Parents to Be Parents." American journal of perinatology, vol. 40, no. 12, 2023, pp. 1373-1377.
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Perinatal palliative care refers to a coordinated care strategy that comprises options for obstetric and newborn care that include a focus on maximizing quality of life and comfort for newborns with a variety of conditions considered to be life-limiting in early infancy. With a dual focus on ameliorating suffering and honoring patient values, perinatal palliative care can be provided concurrently with life-prolonging treatment. The focus of this document, however, involves the provision of exclusively palliative care without intent to prolong life in the context of a life-limiting condition, otherwise known as perinatal palliative comfort care. Once a life-limiting diagnosis is suspected antenatally, the tenets of informed consent require that the pregnant patient be given information of sufficient depth and breadth to make an informed, voluntary choice for her care. Health care providers are encouraged to model effective, compassionate communication that respects patient cultural beliefs and values and to promote shared decision making with patients. Perinatal palliative comfort care is one of several options along a spectrum of care, which includes pregnancy termination (abortion) and full neonatal resuscitation and treatment, that should be presented to pregnant patients faced with pregnancies complicated by life-limiting fetal conditions. If a patient opts to pursue perinatal palliative comfort care, a multidisciplinary team should be identified with the infrastructure and support to administer this care. The perinatal palliative care team should prepare families for the possibility that there may be differences of opinion between family members before and after the delivery of the infant, and that there may be differences between parents and the neonatal care providers about appropriate postnatal therapies, especially if the postnatal diagnosis and prognosis differ substantially from antenatal predictions. Procedures for resolving such differences should be discussed with families ahead of time.
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