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Neonatal COVID-19 – the Past, Present and the Future
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Source: Seminars in Fetal and Neonatal Medicine - May 6, 2023 Category: Perinatology & Neonatology Authors: Satyan Lakshminrusimha, Herman L. Hedriana Tags: Editorial Source Type: research

Decision-making for extremely preterm infants with severe hemorrhages on head ultrasound: science, values, and communication skills
Severe intracranial hemorrhages are not rare in extremely preterm infants. They occur early, generally when babies require life-sustaining interventions. This may lead to ethical discussions and decision-making about levels of care. Prognosis is variable and depends on the extent, location, and laterality of the lesions, and, importantly also on the subsequent occurrence of other clinical complications or progressive ventricular dilatation. Decision-making should depend on prognosis and parental values. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - April 27, 2023 Category: Perinatology & Neonatology Authors: M. Chevallier, K.J. Barrington, P. Terrien Church, T.M. Luu, A. Janvier Source Type: research

Counseling for the option of termination of pregnancy for severe fetal anomalies in light of the recent Supreme Court ruling to remove the constitutional right to an abortion
A birth defect is a structural or chromosomal change present at birth that can affect almost any part or parts of the body. Birth defects can vary from mild to severe. On June 24, 2022, with its Dobbs v Jackson Women's Health Organization decision the Supreme Court of the United States overturned Roe v. Wade, removing the longstanding landmark 1973 ruling that secured a person's constitutional right to an abortion. With this decision individual states can now decide their own abortion laws. In about one-half of the states that continue the legality of pregnancy termination, the process of offering, discussing, and performi...
Source: Seminars in Fetal and Neonatal Medicine - April 24, 2023 Category: Perinatology & Neonatology Authors: Amos Gr ünebaum, Jonathan D. Moreno, Susan Pollet Esq, Frank A. Chervenak Source Type: research

Counselling for the option of termination of pregnancy for severe fetal anomalies in light of the recent Supreme Court ruling to remove the constitutional right to an abortion
A birth defect is a structural or chromosomal change present at birth that can affect almost any part or parts of the body. Birth defects can vary from mild to severe. On June 24, 2022, with its Dobbs v Jackson Women ’s Health Organization decision the Supreme Court of the United States overturned Roe v. Wade, removing the longstanding landmark 1973 ruling that secured a person’s constitutional right to an abortion. With this decision individual states can now decide their own abortion laws. In about one-hal f of the states that continue the legality of pregnancy termination, the process of offering, discussing, and pe...
Source: Seminars in Fetal and Neonatal Medicine - April 24, 2023 Category: Perinatology & Neonatology Authors: Amos Gr ünebaum, Jonathan D. Moreno, Susan Pollet Esq, Frank A. Chervenak Source Type: research

Paediatric palliative care in the NICU: a new era of integration
We are entering a new era of integration between neonatal medicine and paediatric palliative care, with increasing recognition that the role and skills of palliative care extend beyond care of only the terminally ill infant. This paper addresses the principles of paediatric palliative care and how they apply in the NICU, considers who provides palliative care in this setting and outlines the key components of care. We consider how the international standards of palliative care pertain to neonatal medicine and how a fully integrated approach to care may be realised across these two disciplines. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - April 20, 2023 Category: Perinatology & Neonatology Authors: Sophie Bertaud, Angela M. Montgomery, Finella Craig Source Type: research

Spiritual and Cultural Influences on End-of-Life Care and Decision-Making in NICU
Understanding and respecting the spiritual beliefs, ethnic roots, cultural norms and customs of individual families is essential for neonatologists to provide clinically appropriate and humane end-of-life care. This review describes the religious/philosophical principles, cultural-related practices/rituals, and traditions in end-of-life care in major spiritual groups of today ’s multi-cultural, multi-faith societies. The spiritual groups include Christians, Muslims, Jewish Judaism believers and Asian religious/philosophy followers such as Buddhists, Hindus, Taoists, Confucianism devotees and ancestral worshippers. (Sourc...
Source: Seminars in Fetal and Neonatal Medicine - April 20, 2023 Category: Perinatology & Neonatology Authors: Pak C. Ng, Genevieve P.G. Fung Source Type: research

Ethics at the End of Life in the Newborn Intensive Care Unit: Conversations and Decisions
The unexpected birth of a critically ill baby raises many ethical questions for neonatologists. Some of these are obviously ethical questions, about whether to attempt resuscitation, and, if the baby is resuscitated and survives, whether to continue life sustaining interventions. Other ethical decisions are more related to what to say rather than what to do. Although less obvious, they are equally as important, and may also have far-reaching ramifications. This essay presents the story of a newborn with profound hypoxic-ischemic encephalopathy, and reviews decisions regarding resuscitation, withdrawal of mechanical ventila...
Source: Seminars in Fetal and Neonatal Medicine - April 20, 2023 Category: Perinatology & Neonatology Authors: Mark R. Mercurio, Lynn Gillam Source Type: research

End of life care in the setting of extreme prematurity – practical challenges and ethical controversies
While the underlying principles are the same, there are differences in practice in end of life decisions and care for extremely preterm infants compared with other newborns and older children. In this paper, we review end of life care for extremely preterm infants in the delivery room and in the neonatal intensive care unit. We identify potential justifications for differences in the end of life care in this population as well as practical and ethical challenges. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - April 20, 2023 Category: Perinatology & Neonatology Authors: Dominic JC. Wilkinson, Sophie Bertaud Source Type: research

Neonatal euthanasia in the context of palliative and EoL care
Neonatal deaths can be categorized in 5 modes along the dimension of intervention and physiology. This classification can be helpful to analyze the choices that can be made in end-of-life care in the NICU. In the Netherlands, neonatal euthanasia became an optional 6th mode of death since publication and legalization of the Groningen Protocol. This paper summarizes the history, legal status and ethical justification of the Groningen Protocol, and describes end-of-life practice in the subsequent years. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - April 20, 2023 Category: Perinatology & Neonatology Authors: A.A.Eduard Verhagen Source Type: research

Maternal-fetal surgery as part of pediatric palliative care
Maternal-fetal surgical interventions have become a more common part of prenatal care. This third option, beside termination or post-natal interventions, complicates prenatal decision-making: while interventions may be lifesaving, survivors may face a life with disability. Pediatric palliative care (PPC) is more than end of life or hospice care, it aims at helping patients with complex medical conditions live well. In this paper, we briefly discuss maternal-fetal surgery, challenges regarding counseling and benefit-risk evaluation, argue that PPC should be a routine part of prenatal consultation, discuss the pivotal role o...
Source: Seminars in Fetal and Neonatal Medicine - April 20, 2023 Category: Perinatology & Neonatology Authors: Felix R. De Bie, Tyler Tate, Ryan M. Antiel Source Type: research

The Logistics of Withdrawing Life-Sustaining Medical Treatment in the Neonatal Intensive Care Unit
Discussion should include the steps to occur during the withdrawal. Physicians should recommend appropriate withdrawal steps based on family goals. Stepwise approach should be taken only if a family requests. Care should continue for the family and staff after the withdrawal and the infant ’s death. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - April 20, 2023 Category: Perinatology & Neonatology Authors: Erin Rholl, Steven R. Leuthner Source Type: research

Unmasking grief: Reflections on the complicated relationship between moral distress and grief
Perinatal loss often occurs in the context of discovery of a medical condition that presents patients and healthcare providers (HCPs) with difficult choices. Treatment choices are influenced by medical technology, however inescapable prognostic uncertainty, coupled with shared decision-making can lead to ethical dilemmas1. When patients experience perinatal loss HCPs must grapple with their own emotions. Their sense of grief arises from their empathic connection with patients, bearing witness to their grief. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - April 20, 2023 Category: Perinatology & Neonatology Authors: Lucia D. Wocial, John J. Lynch, Ann Hannan Source Type: research

Palliative Care for NICU Survivors with Chronic Critical Illness
The sickest of NICU survivors develop chronic critical illness (CCI). Most infants with CCI will leave the NICU using chronic medical technology and will experience repeated rehospitalizations. The unique issues for these NICU graduates — escalating chronic medical technologies, fractured post-NICU healthcare, gaps in home health services, and family strain—are common and predictable. This means that raising family and NICU team awareness of these issues, and putting plans in place to address them, should occur for every NICU i nfant with CCI. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - April 20, 2023 Category: Perinatology & Neonatology Authors: Renee D. Boss Source Type: research

Extracorporeal Membrane Oxygenation in pregnancy during the SARS-CoV-2 Pandemic
The novel coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the disease the World Health Organization designated COVID-19 (coronavirus disease 2019). To date, there are 761,402,282 cases of COVID-19 globally, with 6,887,000 deaths.1 Pregnant people infected with the SARS-CoV-2 have a variable course with a wide range of clinical symptoms.2 As the pandemic ensues and vaccination rates have increased, many pregnant women have asymptomatic or mild courses of COVID-19 and can be managed as outpatients. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - April 4, 2023 Category: Perinatology & Neonatology Authors: Michael Richley, Rashmi Rao Source Type: research

Editorial Board
(Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - April 1, 2023 Category: Perinatology & Neonatology Source Type: research