Induction of Labor for Maternal Indications at a Periviable Gestational Age; Survey on Management, Reporting and Auditing amongst Dutch Maternal-Fetal Medicine Specialists and Neonatologists

Abstract Background In cases of life-threatening maternal conditions in the periviable period, professionals may consider immediate delivery with fetal demise as a consequence of the treatment. We sought the opinion of involved medical professionals on management, reporting, and auditing in these cases. Methods We performed an online survey amongst all registered maternal-fetal medicine (MFM) specialists and neonatologists in the Netherlands. The survey presented two hypothetical cases of severe early-onset pre-eclampsia at periviable gestational ages. Management consisted of immediate termina... Mehr ...

Verfasser: Leonoor van Eerden
Christianne J.M. de Groot
Godelieve C.M.L. Page-Christiaens
Eva Pajkrt
Gerda G. Zeeman
Antoinette C. Bolte
Dokumenttyp: Artikel
Erscheinungsdatum: 2018
Reihe/Periodikum: American Journal of Perinatology Reports, Vol 08, Iss 04, Pp e295-e300 (2018)
Verlag/Hrsg.: Thieme Medical Publishers
Inc.
Schlagwörter: termination of pregnancy / legislation / survey / mfm specialists / neonatologists / Gynecology and obstetrics / RG1-991
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-27407124
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://doi.org/10.1055/s-0038-1675340

Abstract Background In cases of life-threatening maternal conditions in the periviable period, professionals may consider immediate delivery with fetal demise as a consequence of the treatment. We sought the opinion of involved medical professionals on management, reporting, and auditing in these cases. Methods We performed an online survey amongst all registered maternal-fetal medicine (MFM) specialists and neonatologists in the Netherlands. The survey presented two hypothetical cases of severe early-onset pre-eclampsia at periviable gestational ages. Management consisted of immediate termination or expectant management directed towards newborn survival. Findings In the case managed by immediate termination, 62% percent answered that fetal demise resulting from induction of labor for maternal indications should be audited only within the medical profession. In the case of expectant management, 17% of the participants agreed with this management. Some answers revealed a significant difference in opinion between the medical specialists. Conclusion Perspective of MFM specialists and neonatologists differs with regard to counseling prospect parents in case of severe early onset pre-eclampsia. The majority of professionals is willing to report late termination (after 24 weeks' gestation) for severe maternal disease to medical experts for internal audits but not for legal auditing.