Facilitating home birth in perinatal palliative care: A case report.

IF 3.6 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Sophie Bertaud, Rachel Kirven, Thomas Kirven, Emily Harrop, Amanda Crudgington, Dominic Wilkinson
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Abstract

Background: Perinatal palliative care can offer compassionate support to families following diagnosis of a life-limiting illness, to enable them to make valued choices and the most of the time that they have with their newborn. However, home birth is usually only offered in low-risk pregnancies.

Case: A couple who received an antenatal diagnosis of hypoplastic left heart syndrome and who had made a plan to provide palliative care to their baby after birth requested the option of a home birth.

Possible courses of action: Recommend birth at hospital or explore the possibility of a home birth with perinatal palliative care support.

Formulation of a plan: Multidisciplinary discussion and collaboration enabled a plan for home birth to be made which anticipated potential complications.

Outcome: The baby was born at home and died on day 5 of life receiving outreach nursing, paediatric and palliative care support and buccal and oral opioids for symptom management. We include reflections from the family on the importance of this experience.

Lessons: We provide a list of potential criteria for considering home birth in the setting of perinatal palliative care.

View: Facilitating a home birth in the setting of perinatal palliative care is an option that can be hugely valued by families, but this service may be practically difficult to deliver in many contexts. Further research is needed to understand the preferences of women and families receiving perinatal palliative care.

在围产期姑息治疗中促进家庭分娩:病例报告。
背景:围产期姑息关怀可以为确诊患有危及生命疾病的家庭提供富有同情心的支持,使他们能够做出有价值的选择,并充分利用与新生儿在一起的时间。然而,家庭分娩通常只适用于低风险妊娠:一对夫妇在产前被诊断为左心室发育不全综合症,并计划在婴儿出生后为其提供姑息治疗,他们要求选择在家分娩:可能的行动方案:建议在医院分娩或探索在围产期姑息关怀支持下在家分娩的可能性:制定计划:多学科讨论和合作使在家分娩计划得以制定,并预计到潜在的并发症:结果:婴儿在家中出生,在接受外展护理、儿科和姑息治疗支持以及口腔和口服阿片类药物对症治疗后,于出生后第 5 天死亡。我们还收录了家属对这次经历重要性的反思:我们提供了在围产期姑息关怀背景下考虑家庭分娩的潜在标准清单:观点:在围产期姑息关怀的背景下促进家庭分娩是一种家庭非常重视的选择,但这种服务在许多情况下可能很难提供。要了解接受围产期姑息关怀的妇女和家庭的偏好,还需要进一步的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Palliative Medicine
Palliative Medicine 医学-公共卫生、环境卫生与职业卫生
CiteScore
7.60
自引率
9.10%
发文量
125
审稿时长
6-12 weeks
期刊介绍: Palliative Medicine is a highly ranked, peer reviewed scholarly journal dedicated to improving knowledge and clinical practice in the palliative care of patients with far advanced disease. This outstanding journal features editorials, original papers, review articles, case reports, correspondence and book reviews. Essential reading for all members of the palliative care team. This journal is a member of the Committee on Publication Ethics (COPE).
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