Tosello Barthélémy, Haddad Grace, Gire Catherine, Einaudi Marie-Ange
a Aix-Marseille University/EFS/CNRS, UMR 7268 ADÉS, Espace Éthique Méditerranéen, Hospital La Timone , Marseille , France and.
b Department of Neonatology , Assistance Publique-Hôpitaux De Marseille, Hospital Nord , Marseille , France.
J Matern Fetal Neonatal Med. 2017 Mar;30(6):755-758. doi: 10.1080/14767058.2016.1186633. Epub 2016 May 26.
Some of the antenatally diagnosed fetal pathologies are unlikely to get compatible with life. Still some women choose to continue with pregnancy. Subsequently, perinatal palliative care (PPC) has become a constructive demarche in such situations. Our study, based on a multicentric survey, reports some cases of fetal pathologies considered as lethal according to perinatal professionals and reveals the decisional process in each case.
We sent by emails a questionnaire to 434 maternal-fetal medicine specialists and fetal care pediatric specialists at 48 multidisciplinary centers for prenatal diagnosis.
The participation rate was 49.3%. In total, 61 obstetric-gynecologists and 68 neonatologists completed the survey. The results showed that 35.4% of the pregnant women asked for the continuation of pregnancy and 24.7% asked for the termination of pregnancy. More than half of professionals (52.9%) took the initiative of informing women about the options for birth support (including PPC), while 32.7% of obstetric gynecologists did not take this initiative versus 10.2% of neonatologists (p < 0.01).
This study demonstrates the absolute need to provide PPC training for professionals and to standardize its practices.
一些产前诊断出的胎儿疾病不太可能存活。然而，仍有一些女性选择继续妊娠。随后，围产期姑息治疗（PPC）在这种情况下成为一种建设性的举措。我们基于多中心调查的研究报告了一些被围产期专业人员视为致命的胎儿疾病病例，并揭示了每个病例中的决策过程。
我们通过电子邮件向48个多学科产前诊断中心的434名母胎医学专家和胎儿护理儿科专家发送了一份问卷。
参与率为49.3%。共有61名妇产科医生和68名新生儿科医生完成了调查。结果显示，35.4%的孕妇要求继续妊娠，24.7%的孕妇要求终止妊娠。超过一半的专业人员（52.9%）主动向女性告知分娩支持选项（包括PPC），而32.7%的妇产科医生没有采取这一主动行为，相比之下新生儿科医生的这一比例为10.2%（p < 0.01）。
本研究表明，绝对有必要为专业人员提供PPC培训并规范其操作。
