Perinatal hospice.

N J Hoeldtke; B C Calhoun

doi:10.1067/mob.2001.116093

Home/Archive/PubMed

PubMed · 11568772

Perinatal hospice.

N J Hoeldtke·B C Calhoun

View original source ↗Export metadata ↓

Abstract

When the prenatal diagnosis of a lethal fetal anomaly has been established, some patients choose to continue their pregnancy. Currently, there is a paucity of medical literature addressing the specific management of families in this unique circumstance. We propose a model of care that incorporates the strengths of prenatal diagnosis, perinatal grief management, and hospice care to address the needs of these families. We discuss the identification of candidates for this form of care; the multidisciplinary team approach; and the aspects of antepartum, intrapartum, and postpartum care. Finally, we discuss some barriers that might need to be overcome when attempting to implement perinatal hospice care.

Explore related subjects

Congenital Abnormalities Grief Hospices Humans Infant Care Infant, Newborn Prenatal Care Prenatal Diagnosis Journal Article Review

Keep this discovery

Explore connections, maps & timelines

BibTeX RIS

N J Hoeldtke, B C Calhoun. 2001. Perinatal hospice.. https://doi.org/10.1067/mob.2001.116093

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2007

Hospital stays, hospital charges, and in-hospital deaths among infants with selected birth defects--United States, 2003.

Birth defects (BDs) are conditions that 1) result from a malformation, deformation, or disruption in one or more parts of the body; 2) are present at birth; and 3) have a serious, adverse effect on health, development, or functional ability. BDs are leading causes of pediatric hospitalizations, medical expenditures, and infant mortality. To estimate national hospital charges and rates of in-hospital deaths for a greater number of specific BDs than estimated in previous reports, investigators at the University of Arkansas for Medical Sciences and CDC used the Healthcare Cost and Utilization Project 2003 Kids' Inpatient Database (KID), developed and distributed by the Agency for Healthcare Research and Quality. KID is a 10% sample of hospital discharges after uncomplicated births and an 80% sample of all other pediatric discharges from 36 participating states. Data are weighted to represent all pediatric hospitalizations in the United States. The investigators analyzed hospital stays during 2003 for newborn infants with any of 35 BDs. This report describes the results of that analysis, which indicated substantial variation among BDs regarding average length of stay, average hospital charge, and the incidence of in-hospital deaths. Average length of stay was greatest for infants with surgically repaired gastroschisis or omphalocele. Average hospital charges were highest for infants with hypoplastic left heart syndrome and common truncus arteriosus. Although anencephaly, trisomy 13, and trisomy 18 were associated with the highest rates of in-hospital death, the largest total numbers of deaths associated with neonatal hospitalizations occurred in infants with diaphragmatic hernia and renal agenesis. Further studies are needed to distinguish outcomes for infants with isolated and multiple defects and to assess longer-term outcomes.

Congenital Abnormalities↗

PubMed2007

False positives in the prenatal ultrasound screening of fetal structural anomalies.

OBJECTIVE: To describe the false-positive diagnoses of prenatal ultrasound screening of fetal structural anomalies. METHODS: Pregnancies with fetal structural anomalies either detected prenatally in our center or referred to us, were registered, evaluated, and followed-up prospectively by a multidisciplinary Congenital Defects Committee. After postnatal follow-up was completed, cases were assigned as true positives, false positives or false negatives and categorized by anatomical systems. Pregnancies referred with a nonconfirmed suspicion of anomaly were not included. The false-positive diagnoses were analyzed. RESULTS: From 1994 to 2004, 903 new registry entries of fetuses structurally abnormal at ultrasound with a complete follow-up were included in the Committee database. There were 76 false positives, accounting for 9.3% of all the prenatally established diagnoses. The urinary tract anomalies were the most frequent false-positive diagnoses found (n = 25; accounting for 8.7% of the urinary tract defects), but the genital anomalies showed the higher rate of no confirmation (n = 5; 15.2%). The specific anomalies most commonly not confirmed were renal pyelectasis (n = 9), cerebral ventriculomegaly (n = 9), abdominal cysts (n = 7) and short limbs (n = 7). CONCLUSION: Several prenatally diagnosed anomalies would benefit from prudent counseling, because they may be normal variants or transient findings.

Congenital Abnormalities↗

PubMed2007

End-of-life care for infants.

Carey, diagnosed with Trisomy 13, was 4 months old when he died. The moment of his death was really quite beautiful. He looked so peaceful resting in his mother's arms. She kissed him softly and said her good-byes. Tears stained her cheeks as Carey's father gently put his arms around both of them. They relaxed as he took his last breath, confident that they had done their best in caring for him. They had given Carey the best 4 months he could have. They will always remember him. After a few moments alone with Carey, they handed him to the hospice nurse. She and the social worker took care of the last-minute arrangements while the extended family members consoled one another. That night, the family began a new phase of their journey, carrying the memories of Carey and his life with them forever.

Congenital Abnormalities↗