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Prenatal multidisciplinary counseling for fetal congenital anomalies: A narrative review
Licia Lugli1, Cecilia Rossi1, Alberto Berardi1
1Neonatology Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy.
Insights
Prenatal multidisciplinary counseling offers comprehensive support for fetal congenital anomalies. This collaborative approach empowers parents with information and emotional support for informed decision-making.
Area of Science:
- Maternal-Fetal Medicine
- Genetics
- Pediatric Subspecialties
Background:
- Prenatal diagnosis of fetal congenital anomalies necessitates a coordinated medical approach.
- Multidisciplinary teams integrate various specialists to manage complex cases.
Purpose of the Study:
- To outline the framework of prenatal multidisciplinary counseling for fetal anomalies.
- To emphasize the importance of informed decision-making for expectant parents.
Main Methods:
- Collaborative care involving genetic counselors, obstetricians, neonatologists, and other specialists.
- Comprehensive assessment of medical, psychological, and ethical aspects.
- Facilitating open communication and addressing parental concerns.
Main Results:
- Categorization of prenatal anomaly scenarios: surgically correctable, genetic/disabling, lethal, and undefined.
- Discussion of pregnancy termination, treatment options, and emotional support.
- Provision of ongoing support throughout pregnancy and postpartum preparation.
Conclusions:
- Multidisciplinary counseling improves the quality of prenatal care for congenital anomalies.
- Empowers parents to navigate their journey with enhanced information and support.
Introduction:
Prenatal multidisciplinary counseling for fetuses with congenital anomalies involves a collaborative approach, integrating expertise from various medical fields.
Aims And Approach:
This comprehensive strategy aims to provide expectant parents with accurate information about the diagnosis, potential outcomes, and available interventions. Genetic counselors, obstetricians, neonatologists, and other specialists work together to address medical, psychological, and ethical aspects. The prenatal multidisciplinary counseling approach emphasizes open communication, fostering a supportive environment for the couple to express their concerns and ask questions. In the case of prenatally detected fetal congenital anomalies, several different scenarios can be delineated: (1) detection of surgically correctable congenital anomalies, (2) identification of genetic disease or fetal anomalies likely to result in disabilities, (3) discovery of severe and lethal congenital anomalies, and (4) encountering fetal anomalies that are not well-defined, leading to an unclear scenario. The process of counseling includes discussing the possibility of pregnancy termination, treatment options, potential challenges, and emotional support, enabling expectant parents to make informed decisions aligned with their values and preferences. Additionally, the counseling process extends beyond the initial diagnosis, providing ongoing support as the pregnancy progresses and helping families to prepare for the difficulties they may face after the birth of the child with congenital anomalies. This collaborative effort not only focuses on the medical aspects but also considers the emotional and ethical dimensions of decision-making.
Conclusion:
The multidisciplinary approach enhances the quality of care and empower parents, facilitating a more informed and compassionate journey throughout the prenatal period.
