Frontiers in Pediatrics (Jan 2021)

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

  • Marco Bolognani,
  • Marco Bolognani,
  • Paola Daniela Morelli,
  • Isabella Scolari,
  • Cristina Dolci,
  • Valentina Fiorito,
  • Francesca Uez,
  • Silvia Graziani,
  • Barbara Stefani,
  • Barbara Stefani,
  • Francesca Zeni,
  • Francesca Zeni,
  • Gino Gobber,
  • Elena Bravi,
  • Saverio Tateo,
  • Massimo Soffiati

DOI
https://doi.org/10.3389/fped.2020.574397
Journal volume & issue
Vol. 8

Abstract

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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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