Research: Maternal-fetal surgery as part of pediatric palliative care

Semin Fetal Neonatal Med

. 2023 Apr 20;101440.

 doi: 10.1016/j.siny.2023.101440. Online ahead of print.

Maternal-fetal surgery as part of pediatric palliative care

Felix R De Bie 1Tyler Tate 2Ryan M Antiel 3

Affiliations expand


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 of the maternal-fetal surgeon in the PCC-team, and finally discuss some of the ethical considerations of maternal-fetal surgery. We illustrate this with a case example of an infant diagnosed with congenital diaphragmatic hernia (CDH).

Keywords: Maternal-fetal surgery; Pediatric palliative care.

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