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[Ethics in perinatology].

G R Burgio1, A Paganelli, P Sampaolo

  • 1Dipartimento di Scienze Pediatriche, Università degli Studi di Pavia, Pavia. roberto.burgio@unipv.it

Minerva Pediatrica
|March 17, 2006
PubMed
Summary

The perinatal phase, crucial for extremely premature infants, involves complex ethical considerations regarding intensive care. Advances in monitoring and care have improved outcomes for these high-risk neonates.

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Area of Science:

  • Perinatal Medicine
  • Neonatology
  • Bioethics

Context:

  • The perinatal period, from 22-23 weeks gestation to the first weeks of neonatal life, presents unique ethical challenges.
  • Extremely low birth weight newborns (<500g) born before 23 weeks gestation face significant survival and quality-of-life risks.
  • Intensive care decisions for extremely preterm infants necessitate balancing rational medical judgment with emotional considerations.

Purpose:

  • To highlight the ethical complexities surrounding intensive care interventions for extremely preterm neonates.
  • To discuss the impact of neonatal immaturity on survival prognosis and quality of life.
  • To examine the evolving landscape of healthcare programs and guidelines for high-risk perinatal care.

Summary:

  • The perinatal phase is characterized by profound immaturity in extremely low birth weight newborns, impacting survival and quality of life.
  • Neonates born before 23 weeks gestation are at extreme risk, prompting critical healthcare program considerations.
  • Ethical dilemmas persist regarding the extent of intensive care in Neonatal Intensive Care Units (NICUs), especially when communicating severe diagnoses to parents.

Impact:

  • Improved monitoring and care programs for high-risk pregnancies have yielded positive results in recent years.
  • Ethical guidelines for perinatal care are evolving and vary across different countries.
  • Effective communication strategies are essential when delivering difficult diagnoses to parents of newborns, particularly those born preterm.

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