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Development of a Perinatal Palliative Care Model at a Level II Perinatal Center Supported by a Pediatric Palliative Care Network

Objective: To describe the model build up to take care of fetuses and newborns eligible to perinatal palliative care (PnPC) followed in an Italian II level perinatal center. Methods: Retrospective chart review of all fetuses and newborn infants eligible to PnPC admitted to level II perinatal center...

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Autores principales: Bolognani, Marco, Morelli, Paola Daniela, Scolari, Isabella, Dolci, Cristina, Fiorito, Valentina, Uez, Francesca, Graziani, Silvia, Stefani, Barbara, Zeni, Francesca, Gobber, Gino, Bravi, Elena, Tateo, Saverio, Soffiati, Massimo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7845291/
https://www.ncbi.nlm.nih.gov/pubmed/33520884
http://dx.doi.org/10.3389/fped.2020.574397
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author Bolognani, Marco
Morelli, Paola Daniela
Scolari, Isabella
Dolci, Cristina
Fiorito, Valentina
Uez, Francesca
Graziani, Silvia
Stefani, Barbara
Zeni, Francesca
Gobber, Gino
Bravi, Elena
Tateo, Saverio
Soffiati, Massimo
author_facet Bolognani, Marco
Morelli, Paola Daniela
Scolari, Isabella
Dolci, Cristina
Fiorito, Valentina
Uez, Francesca
Graziani, Silvia
Stefani, Barbara
Zeni, Francesca
Gobber, Gino
Bravi, Elena
Tateo, Saverio
Soffiati, Massimo
author_sort Bolognani, Marco
collection PubMed
description Objective: To describe the model build up to take care of fetuses and newborns eligible to perinatal palliative care (PnPC) followed in an Italian II level perinatal center. Methods: Retrospective chart review of all fetuses and newborn infants eligible to PnPC admitted to level II perinatal center within a 4 years period. Results: Forty-five of 848 infants (0.5%) referred to II level NICU were eligible to PnPC. Twenty-seven percentage had fetal diagnosis. Twenty percentage were preterm infants at the limit of viability, 35% were newborns with life limiting or life threatening disease diagnosed in utero or at the postnatal ward, 45% were newborns not responding to intensive care intervention with high health care needs or medical complexity. Fifty-seven percentage of neonates admitted to NICU died before discharge, while 16 (35% of population considered) were discharged home. Median age at death was 4 days after birth, and delivery room death immediately after birth occurred in six patients (13%). Conclusions: Despite the paucity of our population and the high variability in disease trajectories the perinatal palliative care program build up in our region provides a reproducible method for a structured taking in charge of fetuses and neonates eligible to PnPC and their families, from the time of diagnosis to bereavement, in both outpatient and inpatient settings.
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spelling pubmed-78452912021-01-30 Development of a Perinatal Palliative Care Model at a Level II Perinatal Center Supported by a Pediatric Palliative Care Network Bolognani, Marco Morelli, Paola Daniela Scolari, Isabella Dolci, Cristina Fiorito, Valentina Uez, Francesca Graziani, Silvia Stefani, Barbara Zeni, Francesca Gobber, Gino Bravi, Elena Tateo, Saverio Soffiati, Massimo Front Pediatr Pediatrics Objective: To describe the model build up to take care of fetuses and newborns eligible to perinatal palliative care (PnPC) followed in an Italian II level perinatal center. Methods: Retrospective chart review of all fetuses and newborn infants eligible to PnPC admitted to level II perinatal center within a 4 years period. Results: Forty-five of 848 infants (0.5%) referred to II level NICU were eligible to PnPC. Twenty-seven percentage had fetal diagnosis. Twenty percentage were preterm infants at the limit of viability, 35% were newborns with life limiting or life threatening disease diagnosed in utero or at the postnatal ward, 45% were newborns not responding to intensive care intervention with high health care needs or medical complexity. Fifty-seven percentage of neonates admitted to NICU died before discharge, while 16 (35% of population considered) were discharged home. Median age at death was 4 days after birth, and delivery room death immediately after birth occurred in six patients (13%). Conclusions: Despite the paucity of our population and the high variability in disease trajectories the perinatal palliative care program build up in our region provides a reproducible method for a structured taking in charge of fetuses and neonates eligible to PnPC and their families, from the time of diagnosis to bereavement, in both outpatient and inpatient settings. Frontiers Media S.A. 2021-01-15 /pmc/articles/PMC7845291/ /pubmed/33520884 http://dx.doi.org/10.3389/fped.2020.574397 Text en Copyright © 2021 Bolognani, Morelli, Scolari, Dolci, Fiorito, Uez, Graziani, Stefani, Zeni, Gobber, Bravi, Tateo and Soffiati. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). 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
Bolognani, Marco
Morelli, Paola Daniela
Scolari, Isabella
Dolci, Cristina
Fiorito, Valentina
Uez, Francesca
Graziani, Silvia
Stefani, Barbara
Zeni, Francesca
Gobber, Gino
Bravi, Elena
Tateo, Saverio
Soffiati, Massimo
Development of a Perinatal Palliative Care Model at a Level II Perinatal Center Supported by a Pediatric Palliative Care Network
title Development of a Perinatal Palliative Care Model at a Level II Perinatal Center Supported by a Pediatric Palliative Care Network
title_full Development of a Perinatal Palliative Care Model at a Level II Perinatal Center Supported by a Pediatric Palliative Care Network
title_fullStr Development of a Perinatal Palliative Care Model at a Level II Perinatal Center Supported by a Pediatric Palliative Care Network
title_full_unstemmed Development of a Perinatal Palliative Care Model at a Level II Perinatal Center Supported by a Pediatric Palliative Care Network
title_short Development of a Perinatal Palliative Care Model at a Level II Perinatal Center Supported by a Pediatric Palliative Care Network
title_sort development of a perinatal palliative care model at a level ii perinatal center supported by a pediatric palliative care network
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7845291/
https://www.ncbi.nlm.nih.gov/pubmed/33520884
http://dx.doi.org/10.3389/fped.2020.574397
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