Perinatal Counseling I

Perinatal Counseling I

PRENATAL CONSULTATION PRACTICES AT THE BORDER OF VIABILITY: A REGIONAL SURVEY. Bastek, Tara K., et al. PEDIATRICS Vol. 116 No. 2 August 2005, pages 407-413

Objective: This study comes from Harvard where they interviewed practicing Neonatologists in the New England area as to their attitudes and practices regarding prenatal consultations for infants at the border of viability.

Methods: Self-administered anonymous surveys were mailed to practitioners. 85% of the Neonatologists responded.

Results: 77% of respondents indicated that they thought neonatologists and parents should make the decision jointly to withhold resuscitation. 40% indicated that the decision actually is made by both parties. 58% saw their primary role during the prenatal consultation as providing factual information to the parents. Most often, neonatologists discussed short-term outcomes and complications rather than long-term outcomes.

Conclusion: The results showed that neonatologists are quite consistent in discussing clinical issues of short term consequences, but quite varied in discussing social and ethical issues. Few discussed the probability of long term neuro-developmental outcomes.

Comments: Our AAP Guidelines from 2002 recommend to us how to conduct a perinatal consultation in this setting. This survey has made me realize how I too neglect long-term outcomes in my consults (in other words, the “bad news”). We should also think about interviewing our parents later into the hospitalization in order to improve the directness of our consultations. EV.

Additional Comments:

You may add your own comments to the discussion of this topic by selecting : Submit Comments.

Return to top

Hit Counter