Perinatal Palliative Care: ACOG COMMITTEE OPINION, Number 786.

Perinatal Palliative Care: ACOG COMMITTEE OPINION, Number 786. Obstet Gynecol. 2019 Sep;134(3):e84-e89 Authors: Abstract Perinatal palliative care refers to a coordinated care strategy that comprises options for obstetric and newborn care that include a focus on maximizing quality of life and comfort for newborns with a variety of conditions considered to be life-limiting in early infancy. With a dual focus on ameliorating suffering and honoring patient values, perinatal palliative care can be provided concurrently with life-prolonging treatment. The focus of this document, however, involves the provision of exclusively palliative care without intent to prolong life in the context of a life-limiting condition, otherwise known as perinatal palliative comfort care. Once a life-limiting diagnosis is suspected antenatally, the tenets of informed consent require that the pregnant patient be given information of sufficient depth and breadth to make an informed, voluntary choice for her care. Health care providers are encouraged to model effective, compassionate communication that respects patient cultural beliefs and values and to promote shared decision making with patients. Perinatal palliative comfort care is one of several options along a spectrum of care, which includes pregnancy termination (abortion) and full neonatal resuscitation and treatment, that should be presented to pregnant patients faced with pregnancies complicated by life-limiting fetal con...
Source: Obstetrics and Gynecology - Category: OBGYN Tags: Obstet Gynecol Source Type: research

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Abstract Obstetricians and general surgeons frequently navigate the challenges of providing surgical care that is mindful of the unique circumstances of pregnancy. Ensuring pregnant patients have high-quality surgical care is an ethical imperative. Providers should maintain a high index of suspicion for surgical disease to ensure that surgical diagnoses are not missed or inadequately treated. A variety of imaging modalities are used in pregnancy. Surgical management includes laparoscopic and open approaches. Perioperative fetal monitoring should be the subject of multidisciplinary discussion. Symptomatic control i...
Source: The Surgical Clinics of North America - Category: Surgery Authors: Tags: Surg Clin North Am Source Type: research
Authors: Abstract Perinatal palliative care refers to a coordinated care strategy that comprises options for obstetric and newborn care that include a focus on maximizing quality of life and comfort for newborns with a variety of conditions considered to be life-limiting in early infancy. With a dual focus on ameliorating suffering and honoring patient values, perinatal palliative care can be provided concurrently with life-prolonging treatment. The focus of this document, however, involves the provision of exclusively palliative care without intent to prolong life in the context of a life-limiting condition, oth...
Source: Obstetrics and Gynecology - Category: OBGYN Tags: Obstet Gynecol Source Type: research
Obstetricians and general surgeons frequently navigate the challenges of providing surgical care that is mindful of the unique circumstances of pregnancy. Ensuring pregnant patients have high-quality surgical care is an ethical imperative. Providers should maintain a high index of suspicion for surgical disease to ensure that surgical diagnoses are not missed or inadequately treated. A variety of imaging modalities are used in pregnancy. Surgical management includes laparoscopic and open approaches. Perioperative fetal monitoring should be the subject of multidisciplinary discussion. Symptomatic control in pregnancy should...
Source: Surgical Clinics of North America - Category: Surgery Authors: Source Type: research
This study describes the overall outcome in a country where the therapeutic interruption of pregnancy is not available. The medical records of women with prenatal diagnosis of full trisomy of T13 or T18 between October 1994 and October 2017 were analyzed in order to describe their natural outcomes. Thirteen cases of T13 and 29 cases of T18 were included. The miscarriage rate was 9% for T18 and no cases for T13. Intrauterine fetal death occurred in 46% and 52% of cases for T13 and T18, respectively. The rate of live births for T13 was 54%, and the median survival was one day (95% CI -33.55 - 90.40) and 71% died in the first...
Source: Genetics and Molecular Biology - Category: Genetics & Stem Cells Source Type: research
The survival of those born with a single ventricle has improved dramatically over the past 50  years, largely as a result of the widespread use of the Fontan operation and more recently refinements in staging of the palliative surgery pathway. As a result the average age of people with a Fontan circulation is increasing, [1] and many more women are entering their child bearing years. Despi te a significant physical and psychosocial burden, many aspire to parenthood and this number will increase over the coming years.
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Editorial Source Type: research
Abstract JM is a 32-year-old primagravida with polycystic ovary disease. She had extreme difficulty conceiving and was started on clomiphene 6 months ago by her fertility specialist. After doubling the dose on the sixth cycle, she successfully became pregnant. On her second prenatal visit at 12 weeks gestation, an ovarian cyst was detected. Ultrasound showed a complex ovarian mass with nodules on the bowel and abdominal wall. There was mild-to-moderate peritoneal fluid. Cytology showed adenocarcinoma of ovarian origin. Further workup demonstrated advanced stage III epithelial ovarian cancer. JM was referred to GYN...
Source: The American Journal of Hospice and Palliative Care - Category: Palliative Care Authors: Tags: Am J Hosp Palliat Care Source Type: research
Karin Meissner1,2*, Nicola Talsky1, Elisabeth Olliges1,2, Carmen Jacob1,3,4, Oliver J. Stötzer5, Christoph Salat5, Michael Braun6 and Raluca Flondor1 1Institute of Medical Psychology, Faculty of Medicine, LMU Munich, Munich, Germany 2Division of Health Promotion, Coburg University of Applied Sciences, Coburg, Germany 3Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom 4Wessex Neurological Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom 5Haematology and Oncology, Outpatient Cancer Ca...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Conclusion This study described four Chinese LINCL siblings who were diagnosed by WES. The patients of these four families had similar disease courses started from motor regression or seizures to cognition regression and visual loss but carried mutations in different genes i.e. CLN2, CLN5, CLN6, and CLN7. The clinical features of LINCLs in these four Chinese siblings were not significantly different from those of Western patients. However, all Chinese LINCL patients in this study presented similar clinical course despite the affected genes. We assumed it as an ethnic specific clinical course according to our observation. ...
Source: Frontiers in Genetics - Category: Genetics & Stem Cells Source Type: research
Conclusion: Our findings indicate that the genetic test based on WES can be useful in diagnosing SYM1 patients, with particular advantages in preventing the fetus from contacting harmful X-ray through the traditional radiography. The novel pathogenic mutation identified would further expand our understanding of the mutation spectrum of NOG in association with SYM1 disease and provide a guidance on how to determine whether the fetus is affected by SYM1 through the prenatal diagnosis. Introduction Proximal symphalangism (MIM#185800, SYM1) is a rare autosomal dominant bone disorder with principal features of variable ...
Source: Frontiers in Genetics - Category: Genetics & Stem Cells Source Type: research
This article isn ’t going to change your practice. Why am I reviewingBraun et al. ’s survey regarding oncologists’ beliefs, practices, and knowledge regarding medical marijuana use? 1. I went to a Willie Nelson concert and my clothes still reek of marijuana; 2. One of my palliative care fellows is interested in understanding Palliative Care clinicians ’ educational needs regarding marijuana; 3. I visited a dispensary in Pennsylvania where I was told medical marijuana treats diseases ranging from opioid addiction to headaches to nausea and vomiting (in pregnant woman). This annoyed me and I wanted to...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: arnold marijuana oncology physician Source Type: blogs
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