[:en]A case study of end-of-life of a compromised new-borns[:ro]Prezentare de cazuri de nou-născuți grav compromiși[:]

[:en]Anca Angela Simionescu MD, PhD, obstetrics and gynaecology, Filantropia Hospital, Department of Obstetrics and Gynaecology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania

Address for correspondence: email: asimion2002@yahoo.com

Abstract

Care of seriously compromised new-borns diagnosed prenatally becomes a social aspect with the implication for family and practitioners in our country, when an early detection of incurable malformations and growth-restricted foetuses is possible and require a very premature birth. On the other hand, the extraordinary development of prenatal minimally invasive care from a very preterm births, before the third trimester of pregnancy brings hope to families confronted with these particularly serious medical problems.

Objectives:
The purpose of this article is to present the supportive management of five cases of new-borns requiring palliative care in the last 6 month in a level III Maternity in Bucharest, Romania, between January and June 2017.

Materials and methods:
This descriptive study uses data from medical records (reported between January-June 2017). All patients were diagnosed by a multidisciplinary team, which conciliated and discussed the prognostic of the foetal pathology with the parents.

Results:
The gestational age was between 25 to 32 weeks. Two cases of nonimmune hydrops and two cases of intrauterine growth restriction with Doppler abnormalities were diagnosed in our series. The length of stay in the Neonatal Intensive Care Unit before death varied between 10 hours to 15 days; all family members were involved and psychological support was offered by a qualified psychologist and by a medical multidisciplinary team available in our clinic.

Conclusions:
Palliative care is an integral part of a level III Maternity in Neonatal Intensive Care Services. Family involvement is essential and has implications for the mental well-being of the parents.

Key words: compromised new-borns, malformations, end-of-life care, maternity, neonatal intensive care services

(Full text in Romanian)

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