The Importance and Requirement of Palliative Care in Newborn Intensive Care Units

Abstract

Purpose: Palliative care aims to give the necessary support to the mothers and infants / families after birth since the antenatal period. In this study, we aimed to determine the cases those palliative care should be given.

Materials and Methods: Infants with birth weight ≤ 500 gr, gestational age <23 weeks and infants with a lethal or life threatening congenital anomaly or malformation (trismomes, syndromes, severe congenital heart disease, etc.),  severe neonatal encephalopathy sequelae, congenital muscular disease were eligible. Fetus with severe congenital anomaly detected in antenatal follow-ups and resulted in (termination) therapeutic abortion was enrolled.

Results: It has been determined that birth weight ≤ 500gr and / or infants whose gestational age was less than 23 weeks were not alive. Infants with trisomy 13, 18 and severe congenital heart disease, congenital muscle disease, severe neonatal encephalopathy, severe congenital hydrocephaly were determined to require palliative care until the end of life. It was identified that the fetuses which detected severe congenital anomaly and other causes during antenatal visits resulted in termination.

Conclusion: Beginning from the antenatal period, it seems that there is a need for a national cohort that includes indications for palliative care initiation, care / support for family, transition to home, lifelong care and mental services / support.

Keywords

• antenatal,palliative care,newborn,trisomy,congenital anomaly

Yenidoğan Yoğun bakım Ünitelerinde Palyatif Bakımın Önemi ve Gerekliliği

Abstract

Amaç: Palyatif bakım antenatal dönemden itibaren annelere, doğum sonrası bebeklere/ailelerine gerekli desteği vermeyi amaçlamaktadır. Bu çalışmada palyatif bakım verilmesi gereken durumları tespit etmeyi amaçladık.

Gereç ve Yöntem: Yenidoğan yoğunbakım ünitesine yatırılan doğum ağırlığı ≤ 500 gr, gebelik yaşı 23 haftanın altında olan infantlar, ölümcül veya yaşamla bağdaşmayan bir konjenital anomali ya da malformasyonu olan (trizomiler, sendromlar, ağır konjenital kalp hastalığı vs), ağır neonatal ensefalopati sekeli, konjenital kas hastalığı olan infantlar ve antenatal takiplerde ağır konjenital anomali tespit edilerek gebelik sonlandırması (terminasyonu) veya terapötik abortus yapılan gebeler çalışmaya alındı.

Bulgular: Doğum ağırlığı ≤ 500 gr ve/veya gebelik yaşı 23 haftanın altında olan bebeklerden yaşayan olmadığı belirlendi. Trizomi 13,18 ve ağır konjenital kalp hastalığı olan, konjenital kas hastalığı, ağır neonatal ensefalopati, ağır konjenital hidrosefali olan bebeklerin yaşam sonuna kadar palyatif bakım gerekliliği izlendi. Antenatal gebe takiplerinde ağır konjenital anomali ve diğer nedenler saptanan fetusların terminasyonla sonlandığı belirlendi.

Sonuç: Antenatal dönemden itibaren palyatif bakımı başlatma endikasyonlarını açıklayan, ailenin bakımı/desteklenmesi, eve geçiş, ömür boyu bakım ve yas hizmetleri/desteği gibi konuları da içeren ulusal bir rehbere ihtiyaç olduğu görülmektedir.

Keywords

• palyatif bakım,yenidoğan,antenatal,trizomi,konjenital anomali

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