Outcomes of delivery in patients with diagnosed life-limiting fetal condition and evaluation of perinatal palliative care program: a retrospective review of palliative care service over 7 years

被引:0
|
作者
Korzeniewska-Eksterowicz, Aleksandra [1 ,2 ]
Moczulska, Hanna [3 ]
Grzesiak, Mariusz [4 ,5 ]
Kaczmarek, Piotr [6 ]
机构
[1] Med Univ Lodz, Dept Pediat Oncol & Hematol, Pediat Palliat Care Unit, 36-50 Sporna Str, PL-91738 Lodz, Poland
[2] Gajusz Fdn, Pediat Palliat Care Ctr, 87 J Dabrowskiego Str, PL-93271 Lodz, Poland
[3] Med Univ Lodz, Dept Clin Genet, 251 Pomorska Str, PL-92213 Lodz, Poland
[4] Polish Mothers Mem Hosp, Res Inst, Dept Perinatol Obstet & Gynecol, 281-289 Rzgowska Str, PL-93338 Lodz, Poland
[5] Med Univ Lodz, Dept Gynecol & Obstet, 281-289 Rzgowska Str, PL-93338 Lodz, Poland
[6] Polish Mothers Mem Hosp, Res Inst, Dept Gynecol Fertil & Fetal Therapy, 281-289 Rzgowska Str, PL-93338 Lodz, Poland
来源
BMC PALLIATIVE CARE | 2025年 / 24卷 / 01期
关键词
Prenatal diagnosis; Perinatal hospice; Life-limiting fetal condition; TRISOMY-13;
D O I
10.1186/s12904-025-01671-z
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
BackgroundThe parents with a diagnosis of life-limiting fetal condition should receive medical information about the nature of defect, prognosis, possibilities of care and obstetric complications and receive psychological, spiritual, legal support. In our model of care, the perinatal hospice - functioning outside the hospital structure - offers a multidisciplinary support and coordinates care in close cooperation with hospitals. The aims of study are: analysis of the birth outcome in patients with life-limiting fetal conditions, perinatal palliative care model evaluation and analysis of factors affecting earlier contact of patients with perinatal hospice.MethodsWe conducted retrospective reviews of medical records of perinatal hospice patients in 2014-2020. The study population was divided into two groups. Group 1 comprised deliveries which ended with the birth of a living newborn; Group 2: pregnancies with intrauterine fetal death and death during delivery. Separately, we analysed patients who underwent cesarean birth.ResultsOut of 72 families, 68 decided to continue pregnancy. The most common diagnoses were trisomies 18 and 13. In 47 cases, deliveries resulted in a live-born newborn; in 21 pregnancies, fetal death occurred. Nineteen pregnancies were delivered via cesarean on obstetric indications. The time interval from diagnosis to first palliative consultation was, on average, 48 days in group 1 vs. 33 in group 2. Women with stillbirths contacted the hospice at an earlier stage of pregnancy (p = 0.0469), and multidisciplinary team consultation in the hospital took place earlier (p = 0.0045) and in a shorter time interval from the first consultation in hospice (p = 0.0298). Patients who were older and lived in large cities contacted hospice earlier.ConclusionSystem solutions should be considered, obliging the physician to refer the pregnant woman to a perinatal palliative care program. Shortening the interval between diagnosis and palliative care consultation would allow for more effective professional support and more time to prepare the parents for losing a child.
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页数:9
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