The role of palliative care in perinatal care
DOI:
https://doi.org/10.33448/rsd-v12i6.42082Keywords:
Palliative care; Perinatal mortality.Abstract
Perinatal palliative care (PPC) is promoted by a multidisciplinary team and seeks to improve the quality of life of the newborn (NB) with serious illness. The present study aims to analyze published research on fetal palliative care in the period from 2017 to 2022. Integrative literature review conducted in the Virtual Health Library. The descriptors were "palliative care" and "fetal". It was found that the family and professionals involved with a problematic pregnancy develop negative feelings due to the unpreparedness of doctors to communicate bad news. Communication of a somber fetal diagnosis should be empathetic, objective, and truthful in order to assist the family in decision making. Given the diagnosis, a follow-up pregnancy plan should be made, aiming to reduce unnecessary interventions. Perinatal care decisions should be made by the parents with advice from the team. After delivery, the family should be welcomed and oriented about the adoption of palliative care. The measures to be taken in the PPC are individualized, as they depend on the diagnosis and prognosis of the baby. The multidisciplinary team in the care of the NB and their families can offer support for early mourning. Therefore, the relevance of PPC was demonstrated to welcome the family and avoid dysthanasia. The need for further research to understand the situation of fetal PPC nationwide was perceived. Furthermore, it is essential to promote more training of health care teams, including physicians and medical students, in order to improve communication of bad news and palliative care.
References
Alves, A. M. F., França, M. L. R. & Melo, A. K. (2018). Entre o nascer e o morrer: cuidados paliativos nas experiências dos profissionais de saúde. Revista Brasileira em Promoção da Saúde. 31 (1), 1–10.
Bakhbakhi, D., Burden, C., Siassakos, D., Jones, F., Murphy, S., Redshaw, M., Storey, C. & Yoward, F. (2017). Learning from deaths: Parents’ Active Role and Engagement in The review of their Stillbirth/perinatal death (the PARENTS 1 study). BMC Pregnancy Childbirth. 17, 333.
Bolibio, R., Jesus, R. C. A., Oliveira, F. F., Gibelli, M. A. B. C., Benute, G. R. G., Gomes, A. L., Nascimento, N. B. O., Barbosa, T. V. A., Zugaib, M., Francisco, R. P. V. & Bernardes, L. S. (2018). Cuidados paliativos em medicina fetal. Revista de Medicina. 97 (2), 208-215.
Boyle, F. M., Horey, D., Dean, J. H., Lohan, A., Middleton, P. & Flenady, V. (2022). Perinatal bereavement care during COVID-19 in Australian maternity settings. Journal of Perinatal Medicine. 50 (6), 822-831.
Cassidy, P. R. (2018). Qualidade do atendimento após morte intrauterina em hospitais espanhóis: resultados de uma pesquisa online. BMC Gravidez Parto. 18(22).
Dehkordi, Z. R., Kohan, S., Rassouli, M., Zarean, E. & Malekian, A. (2020). Developing a perinatal paliative care service package for women with fetal anomaly diagnosis: protocol for mixed methods study. Reprod Health. 17 (1), 32.
Figueredo, D. V. A. & Souza, A. S. R. (2022). Palliative care in fetal medicine. Revista Brasileira de Saúde Materno Infantil. 21 (4), 975–976.
Furtado-Eraso, S., Escalada-Hernández, P. & Marín-Fernández, B. (2020). Integrative review of emotional care following perinatal loss. Western Journal of Nursing Research. 43 (5).
Gazzola, L. P. L., Leite, H. V. & Gonçalves, G. M. (2020). Comunicando más notícias sobre malformações congênitas: reflexões bioéticas e jurídicas. Revista bioética. 28 (1), 38-46.
Listermar, K. H., Sormunen, T. & Radestad, I. (2020). Perinatal palliative care after a stillbirth – Midwives’ experiences of using Cubitus baby. Women and Birth. 33 (2), 161-164.
Lord, S., Williams, R., Pollard, L., Ives-Baine, L., Wilson, C., Goodman, K. & Rapoport, A. (2022). Reimagining Perinatal Palliative Care: A Broader Role for Support in the Face of Uncertainty. Journal of palliative care. 37 (4), 476–479.
Marc-Aurele, K., Hull, A., Jones, M. & Pretorius, D. (2018). Taxa de referência de um centro de diagnóstico fetal para cuidados paliativos perinatais. Annals Of Palliative Medicine. 7 (2), 177-185.
Ministério da Saúde (2021). Boletim epidemiológico. Anomalias congênitas no Brasil, 2010 a 2019: análise de um prioritário para a vigilância ao nascimento. https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/boletins/epidemiologic os/edicoes/2021/boletim_epidemiologico_svs_6_anoma lias. pdf
Organização Pan-Americana da Saúde (2020). Nascidos com defeitos congênitos: histórias de crianças, pais e profissionais de saúde que prestam cuidados ao longo da vida - OPAS/OMS.
Ostermann, A. C., Frezza, M., Rosa, R. M. & Zen, P. R. G. (2017). Perspectivas otimistas na comunicação de notícias difíceis sobre a formação fetal. Cadernos De Saúde Pública. 33 (8).
Rossini, M. M. & Stamm, A. M. N. F. (2020). Malformação fetal incompatível com a vida: conduta de neonatologistas. Revista de Bioética. 28 (3).
Smith, P., Vasileiou, K. & Jordan, A. (2020). Healthcare professionals' perceptions and experiences of using a cold cot following the loss of a baby: a qualitative study in maternity and neonatal units in the UK. BMC pregnancy and childbirth. 20 (1), 175.
Souza, M. T., Silva, M. D., & Carvalho, R. (2010). Revisão integrativa: o que é e como fazera. Einstein (São Paulo). 8 (1), 102-106.
Vilarrubi, S. N. (2018). El desafío de la cronicidad compleja y la atención paliativa en pediatría. Anales de Pediatria. 88 (1), 1-2.
Yamasaki, M. (2017). Life and Medical Ethics in Pediatric Neurosurgery. Neurologia medico-chirurgica. 57 (2), 101-105.
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Copyright (c) 2023 Larissa Monteiro Silva; Lorena da Silva Gonçalves; Ludmila Mafra Colares; Myriam Dantas Pereira; Lúcio Aparecido Moreira; Síura Aparecida Borges Silva
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