Cortezzo DonnaMaria E, Ellis Kelstan, Schlegel Amy
Division of Neonatal and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
Division of Pain and Palliative Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
Front Pediatr. 2020 Sep 8;8:556. doi: 10.3389/fped.2020.00556. eCollection 2020.
A significant number of pregnancies are complicated by a fetus with a life-limiting diagnosis. As diagnoses are made earlier in the pregnancy, families experience anticipatory grief and are faced with navigating goals of care for a baby that has yet to be born. With the support of the care team, families can begin to grieve, plan, and make meaningful memories during the duration of the pregnancy, the birth of their baby, and life of the child. Creating a palliative care birth plan, which expands beyond the traditional concept for delivery planning to include prenatal, perinatal, and neonatal care has become an important method for parents to process the diagnosis, for parents to document their wishes, and for members of the care team to communicate with the goal of supporting and enhancing the experience of the family. This articles reviews recent and relevant literature on the importance of birth planning and the role of perinatal palliative care when a life-limiting fetal diagnosis is made. The process of birth planning is an important component of perinatal palliative care. Through this process, families can express their fears, values, hopes, and wishes. It also offers an opportunity for providers to communicate these wishes for the remainder of the pregnancy, the delivery, birth, and time afterwards. This has been demonstrated to decrease maternal stress and promote family centered care. Perinatal birth planning is an important component of perinatal palliative care when a fetus has a life-limiting diagnosis. The process of birth planning can be supportive and therapeutic as well as an important communication tool. With multiple practices and designs of perinatal palliative care programs, there are no standard tools even though important components have been identified. Ultimately, the strategies outlined here can be used as advance care planning tools.
相当数量的妊娠会因胎儿患有危及生命的疾病而变得复杂。随着在孕期更早地做出诊断，家庭会经历预期性悲伤，并面临为尚未出生的婴儿确定护理目标的难题。在护理团队的支持下，家庭可以在孕期、婴儿出生以及孩子的生命过程中开始悲伤、规划并创造有意义的回忆。制定一份姑息治疗分娩计划，该计划超越了传统的分娩计划概念，涵盖产前、围产期和新生儿护理，已成为父母处理诊断结果、记录其愿望以及护理团队成员进行沟通的重要方式，其目的是支持和提升家庭的体验。本文回顾了近期有关分娩计划重要性以及做出危及生命的胎儿诊断时围产期姑息治疗作用的相关文献。分娩计划过程是围产期姑息治疗的重要组成部分。通过这个过程，家庭可以表达他们的恐惧、价值观、希望和愿望。它还为医护人员提供了一个机会，以便在孕期剩余时间、分娩、出生及之后的时间里传达这些愿望。这已被证明可以减轻母亲的压力并促进以家庭为中心的护理。当胎儿患有危及生命的疾病时，围产期分娩计划是围产期姑息治疗的重要组成部分。分娩计划过程既可以是支持性和治疗性的，也是一种重要的沟通工具。尽管已经确定了围产期姑息治疗项目的多个重要组成部分，但由于其有多种实践和设计方式，所以尚无标准工具。最终，这里概述的策略可作为预先护理计划工具使用。
