Bode Leah M, Jager Shannon M, Panoch Janet, Hoffman Shelley M, Laitano Tatiana, Kavanaugh Karen, Tucker Edmonds Brownsyne
Indiana University School of Medicine, Indianapolis, IN, USA.
Department of Obstetrics & Gynecology, Indiana University School of Medicine, Indianapolis, IN, USA.
J Perinatol. 2023 Jan;43(1):23-28. doi: 10.1038/s41372-022-01537-9. Epub 2022 Nov 19.
To qualitatively evaluate women's perspectives on shared decision-making for periviable (22-25 weeks' gestational age) mode of delivery (MOD).
Interviews were conducted at two Midwestern academic hospitals with 30 women hospitalized for threatened periviable delivery between September 2016 and January 2018. Prior to delivery (T1) and at 3-months postpartum (T2), MOD-related decision-making was explored using prompts. Interviews were coded and analyzed using NVivo 12.
The majority of women perceived the MOD options as cesarean section or vaginal delivery. Most ultimately preferred "whatever's best for baby." Understanding of MOD risks was limited, and physicians recommended each option equally. Sixteen participants perceived themselves as decision-makers at T1, while at T2, only nine participants identified themselves as such.
Informed deference is introduced as a novel concept in the setting of periviable MOD decision-making, whereby the mother defers decisional authority to the provider, the baby, a higher power, or the circumstance itself.
定性评估女性对于孕22至25周可存活孕周分娩方式（MOD）共同决策的观点。
在两家中西部学术医院对2016年9月至2018年1月期间因孕22至25周分娩受威胁而住院的30名女性进行访谈。在分娩前（T1）和产后3个月（T2），使用提示语探讨与MOD相关的决策。使用NVivo 12对访谈进行编码和分析。
大多数女性认为MOD选项为剖宫产或阴道分娩。大多数人最终倾向于“对宝宝最好的方式”。对MOD风险的了解有限，医生对每种选项的推荐程度相同。16名参与者在T1时将自己视为决策者，而在T2时，只有9名参与者认为自己是决策者。
在孕22至25周可存活孕周MOD决策背景下引入了知情顺从这一新概念，即母亲将决策权交给医护人员、婴儿、更高权力或情况本身。
