Comfort care plan to periviable infants: associated decision reversals and missed opportunity of antenatal steroids. (12th December 2022)

• Record Type: Journal Article
• Authors: Pandey, Rajesh
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 35:Number 25(2022)
• Page Start: 6699
• Page End: 6703
• Publication Date: 2022-12-12
• Subjects: Prenatal counseling -- antenatal steroids -- active care -- comfort care -- decision reversals; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.1080/14767058.2021.1920009
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Objective: This study aims to identify how often families of periviable infants had a care plan stating whether to provide active or comfort care and how often the care plan was reversed, close to or after the delivery. Study design: In this retrospective study, we reviewed the medical records of all mother-infant dyads (single or twin infants with no known congenital anomalies) who were delivered between 23 0/7 and 24 6/7 weeks gestational age from January 2012 to December 2016. Result: Ninety-nine women met the inclusion criteria − 6 (6%) did not have a care plan available, 85 women (86%) chose for active care and received antenatal steroids (ANS). Six women (6%) who chose comfort care and two women (2%) who chose limited resuscitation during antenatal counseling opted out of the ANS. Two thirds of the women (4/6) who initially opted for comfort care later desired active care, while none of the women who chose active care reversed their decisions. Conclusion: The majorities of the families (94%) had a prenatal care plan in place. Two-thirds (4/6) of the families who opted for comfort care changed their decisions resulting in a missed opportunity for ANS.