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Role of palliative care in centers performing maternal–fetal interventions

Advancements in maternal–fetal interventions have allowed for direct fetal access, shifting the focus of interventions from maternal health for fetal health to a focus on sole fetal/neonatal benefit. Given that access to the fetus can only be obtained through the mother, there are ethical considerat...

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Autores principales: Rholl, Erin, Leuthner, Steven R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10360186/
https://www.ncbi.nlm.nih.gov/pubmed/37484772
http://dx.doi.org/10.3389/fped.2023.1223710
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author Rholl, Erin
Leuthner, Steven R.
author_facet Rholl, Erin
Leuthner, Steven R.
author_sort Rholl, Erin
collection PubMed
description Advancements in maternal–fetal interventions have allowed for direct fetal access, shifting the focus of interventions from maternal health for fetal health to a focus on sole fetal/neonatal benefit. Given that access to the fetus can only be obtained through the mother, there are ethical considerations important to consider when counseling the maternal–fetal dyad. The goals of maternal–fetal interventions range from improved fetal/neonatal survival to decreased long-term morbidities and improved quality of life. However, interventions to improve quality of life may not always achieve their desired result. Additionally, maternal–fetal interventions have risks such as premature birth and other complications that should be heavily considered as they may offset the potential benefits of the procedure. While some families elect for a maternal–fetal intervention, doing every potential postnatal intervention may not be in alignment with their goals depending on the outcome of the intervention. Given the complex, value-laden decision-making that is crucial to counseling parents about decisions surrounding maternal–fetal interventions and subsequent neonatal care, palliative care specialists should be utilized in fetal centers. Palliative care specialists are trained to assist with complex, goal concordant decision-making and can guide families and medical teams through the decision points that arise during the treatment journey.
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spelling pubmed-103601862023-07-22 Role of palliative care in centers performing maternal–fetal interventions Rholl, Erin Leuthner, Steven R. Front Pediatr Pediatrics Advancements in maternal–fetal interventions have allowed for direct fetal access, shifting the focus of interventions from maternal health for fetal health to a focus on sole fetal/neonatal benefit. Given that access to the fetus can only be obtained through the mother, there are ethical considerations important to consider when counseling the maternal–fetal dyad. The goals of maternal–fetal interventions range from improved fetal/neonatal survival to decreased long-term morbidities and improved quality of life. However, interventions to improve quality of life may not always achieve their desired result. Additionally, maternal–fetal interventions have risks such as premature birth and other complications that should be heavily considered as they may offset the potential benefits of the procedure. While some families elect for a maternal–fetal intervention, doing every potential postnatal intervention may not be in alignment with their goals depending on the outcome of the intervention. Given the complex, value-laden decision-making that is crucial to counseling parents about decisions surrounding maternal–fetal interventions and subsequent neonatal care, palliative care specialists should be utilized in fetal centers. Palliative care specialists are trained to assist with complex, goal concordant decision-making and can guide families and medical teams through the decision points that arise during the treatment journey. Frontiers Media S.A. 2023-07-07 /pmc/articles/PMC10360186/ /pubmed/37484772 http://dx.doi.org/10.3389/fped.2023.1223710 Text en © 2023 Rholl and Leuthner. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Rholl, Erin
Leuthner, Steven R.
Role of palliative care in centers performing maternal–fetal interventions
title Role of palliative care in centers performing maternal–fetal interventions
title_full Role of palliative care in centers performing maternal–fetal interventions
title_fullStr Role of palliative care in centers performing maternal–fetal interventions
title_full_unstemmed Role of palliative care in centers performing maternal–fetal interventions
title_short Role of palliative care in centers performing maternal–fetal interventions
title_sort role of palliative care in centers performing maternal–fetal interventions
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10360186/
https://www.ncbi.nlm.nih.gov/pubmed/37484772
http://dx.doi.org/10.3389/fped.2023.1223710
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