TY - CHAP M1 - Book, Section TI - Prenatal Diagnosis and Consultation A1 - Hintz, Susan A1 - Chueh, Jane A1 - Barth, Richard A1 - Cunniff, Christopher A1 - Hudgins, Louanne A2 - Stevenson, David K. A2 - Cohen, Ronald S. A2 - Sunshine, Philip PY - 2015 T2 - Neonatology: Clinical Practice and Procedures AB - Advances in prenatal diagnosis, imaging, and prenatal maternal-fetal and postnatal neonatal care have led to dramatically expanded opportunities and challenges for fetal management and prenatal counseling. Over the recent decades, medical and surgical treatment options for newborns with even the most complex congenital anomalies have substantially increased. Concurrently, prenatal screening and diagnostic capabilities have expanded, leading to early diagnosis of fetal problems. Maternal and family anxiety have been shown to be significantly reduced after antenatal consultation by an experienced, specialized staff.1,2 Nevertheless, depending on the specific fetal finding, the physician and family may still be left with significant uncertainty regarding outcomes. If the pregnancy is continued, management strategies for the expectant mother and fetus range from those narrowly focused on maternal or fetal well-being to pursuing prenatal interventions, which may now be offered for some fetal indications. How these strategies are presented, and by whom, may strongly affect an expectant mother’s decisions.3,4 Furthermore, incomplete communication and collaboration among medical and surgical subspecialists in complex fetal cases may lead to incorrect information dissemination, confused message framing for the family, and a muddied picture of maternal, fetal, and neonatal risk-benefit and outcomes.5 Finally, learning that an eagerly awaited child may be born with congenital anomalies can be the most emotionally stressful and difficult period in the life of an expectant mother or father; for some, the experience constitutes a true psychiatric trauma.6 Therefore, experienced personnel in support services, including medical social services, palliative care, and biomedical ethics, must be available for expectant mothers and families in these circumstances. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/19 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1109791552 ER -