The Role of Perinatal Palliative Care in Fetal Neurology.
Journal
American journal of perinatology
ISSN: 1098-8785
Titre abrégé: Am J Perinatol
Pays: United States
ID NLM: 8405212
Informations de publication
Date de publication:
09 2023
09 2023
Historique:
pmc-release:
01
09
2024
medline:
28
8
2023
pubmed:
29
10
2021
entrez:
28
10
2021
Statut:
ppublish
Résumé
Many serious or life-threatening neurologic conditions are first diagnosed during the fetal period, often following a routine ultrasound or sonographic evaluation after an abnormal aneuploidy screen. Such conditions represent a worrisome or unexpected finding for expectant parents, making the perinatal period a critical time point to engage and empower families encountering complex neurologic clinical scenarios. This review covers the role of perinatal palliative care in these settings. This study is a topical review RESULTS: The prenatal identification of structural abnormalities of the brain or spinal cord, radiographic signs of hemorrhage or ischemic injury, or evidence of genetic or metabolic conditions should prompt involvement of a fetal palliative care team. The inherent prognostic uncertainty is challenging for prenatally diagnosed neurologic conditions which have difficult to predict short and long-term outcomes. While many of these conditions lead to the birth of an infant with neurodevelopmental challenges, few result in in utero demise. Palliative care beginning in the perinatal period provides an additional layer of support for families navigating complex decision-making during their pregnancy and provides continuity of care into the newborn period. Palliative care principles can help guide discussions around genetic and other diagnostic testing, fetal surgery, and birth planning. A multidisciplinary team can help support families with decision-making and through bereavement care in the setting of fetal or neonatal death. Early palliative care team involvement can provide a more holistic approach to counseling, facilitate planning, and ensure that a family's goals and wishes are acknowledged throughout an infant's care trajectory. · Many serious or life-threatening neurologic conditions are diagnosed during the fetal period.. · Palliative care principles should be incorporated in the fetal period for affected patients.. · Palliative care clinicians can aid parents and clinicians in shared decision-making.. · Palliative care principles should be employed by all care providers in relevant cases..
Identifiants
pubmed: 34710944
doi: 10.1055/a-1682-2798
pmc: PMC9619414
mid: NIHMS1843774
doi:
Types de publication
Review
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1265-1271Subventions
Organisme : NINDS NIH HHS
ID : K23 NS116453
Pays : United States
Informations de copyright
Thieme. All rights reserved.
Déclaration de conflit d'intérêts
M.E.L. has received compensation for medicolegal work. Other authors report no conflict of interest.
Références
J Genet Couns. 2007 Oct;16(5):655-61
pubmed: 17674167
Soc Sci Med. 2016 Apr;154:100-9
pubmed: 26954999
J Perinatol. 2016 May;36(5):331-7
pubmed: 26658120
J Perinat Neonatal Nurs. 2006 Jan-Mar;20(1):113-6
pubmed: 16508478
J Perinatol. 2014 Jun;34(6):483-7
pubmed: 24651733
Am J Obstet Gynecol. 2020 Dec;223(6):B13-B16
pubmed: 33168217
Pediatrics. 2006 Sep;118(3):e719-29
pubmed: 16950963
Obstet Gynecol. 2006 May;107(5):1087-97
pubmed: 16648415
Prenat Diagn. 2011 Dec;31(13):1251-8
pubmed: 22028300
Acta Obstet Gynecol Scand. 2016 Aug;95(8):934-40
pubmed: 27061422
Am J Perinatol. 2012 Jan;29(1):7-18
pubmed: 21833896
Genet Med. 2020 Apr;22(4):675-680
pubmed: 31911674
N Engl J Med. 2018 Nov 29;379(22):2089-2091
pubmed: 30485778
Clin Perinatol. 2009 Jun;36(2):237-46, vii-viii
pubmed: 19559318
Ultrasound Obstet Gynecol. 2015 Mar;45(3):249-66
pubmed: 25639627
Eur J Obstet Gynecol Reprod Biol. 2017 Mar;210:201-206
pubmed: 28061423
J Pain Symptom Manage. 2018 Jan;55(1):117-131
pubmed: 28807702
J Ultrasound Med. 2017 Sep;36(9):1809-1817
pubmed: 28523762
Orphanet J Rare Dis. 2007 Feb 02;2:8
pubmed: 17274816
J Pediatr Health Care. 2017 Jan - Feb;31(1):96-103
pubmed: 27245660
Semin Pediatr Neurol. 2014 Dec;21(4):241-7
pubmed: 25727505
Arch Dis Child Fetal Neonatal Ed. 2017 Jan;102(1):F12-F16
pubmed: 27638112
Obstet Gynecol. 2009 Feb;113(2 Pt 1):402-7
pubmed: 19155913
Am J Obstet Gynecol. 2008 Feb;198(2):161.e1-4
pubmed: 18226612
CA Cancer J Clin. 2015 Jul-Aug;65(4):316-33
pubmed: 25955682
Obstet Gynecol Clin North Am. 2018 Mar;45(1):69-81
pubmed: 29428287
Fetal Pediatr Pathol. 2017 Jun;36(3):203-212
pubmed: 28332892
Neonatal Netw. 2005 May-Jun;24(3):35-46
pubmed: 15960010
South Med J. 2004 Dec;97(12):1158-64
pubmed: 15646750
Obstet Gynecol Clin North Am. 2020 Sep;47(3):439-451
pubmed: 32762929
J Perinatol. 2015 Dec;35 Suppl 1:S19-23
pubmed: 26597801
Arch Intern Med. 2007 Dec 10;167(22):2509-15
pubmed: 18071175
J Psychosom Obstet Gynaecol. 2006 Dec;27(4):245-56
pubmed: 17225626
N Engl J Med. 2011 Mar 17;364(11):993-1004
pubmed: 21306277
J Perinatol. 2011 Jun;31(6):387-91
pubmed: 21164425
Rev Obstet Gynecol. 2013;6(2):48-62
pubmed: 24466384
Neurol Clin Pract. 2016 Feb;6(1):40-48
pubmed: 26918202