Division of Paediatric Medicine, Hospital for Sick Children, Toronto, Canada.
Paediatric Advanced Care Team, Hospital for Sick Children, Toronto, Canada.
J Palliat Care. 2022 Oct;37(4):476-479. doi: 10.1177/08258597221098496. Epub 2022 Jun 3.
Perinatal medicine is confronted by a growing number of complex fetal conditions that can be diagnosed prenatally. The evolution of potentially life-prolonging interventions for the baby before and after birth contributes to prognostic uncertainty. For clinicians who counsel families in these circumstances, determining which ones might benefit from early palliative care referral can be challenging. We assert that all women carrying a fetus diagnosed with a life-threatening condition for which comfort-focused care at birth is one ethically reasonable option ought to be offered palliative care support prenatally, regardless of the chosen plan of care. Early palliative care support can contribute to informed decision making, enhance psychological and grief support, and provide opportunities for care planning that includes ways to respect and honor the life of the fetus or baby, however long it may be.
围产医学面临着越来越多的复杂胎儿疾病，可以在产前进行诊断。在出生前和出生后为婴儿延长生命的潜在干预措施的发展增加了预后的不确定性。对于在这种情况下为家庭提供咨询的临床医生来说，确定哪些家庭可能受益于早期姑息治疗转诊可能具有挑战性。我们断言，所有携带胎儿的女性，这些胎儿被诊断患有危及生命的疾病，出生时以舒适为中心的护理是一种合理的选择，都应该在产前获得姑息治疗支持，而不论所选择的护理计划如何。早期姑息治疗支持可以帮助做出明智的决策，增强心理和悲伤支持，并提供护理计划的机会，包括尊重和尊重胎儿或婴儿生命的方式，无论其生命有多长。
