RT Book, Section
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
SR Print(0)
ID 1109791552
T1 Prenatal Diagnosis and Consultation
T2 Neonatology: Clinical Practice and Procedures
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 9780071763769
LK accesspediatrics.mhmedical.com/content.aspx?aid=1109791552
RD 2024/04/20
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.