The First 13 Years of "Percorso Giacomo": Patients' Outcomes

Area of Science:

• Perinatal medicine
• Palliative care
• Neonatology

Background:

• Life-limiting (LL) and life-threatening (LT) diagnoses in fetuses and neonates present complex challenges for families.
• Perinatal palliative care (PPC) services aim to support these families throughout the pregnancy and postpartum period.
• The Percorso Giacomo (PG) service in Italy provides specialized care for such cases.

Purpose of the Study:

• To evaluate the outcomes of fetuses and neonates receiving care from the Percorso Giacomo (PG) perinatal palliative care service.
• To understand the impact of PPC on parental decision-making and care goals for infants with adverse prognoses.

Main Methods:

• Retrospective cohort study at a single center (IRCCS Policlinico di Sant'Orsola, Bologna, Italy) from 2013 to 2025.
• Inclusion of all fetuses and neonates diagnosed prenatally or postnatally with LL or LT conditions whose families chose to continue the pregnancy.
• Analysis of care plans and outcomes for 83 infants.

Main Results:

• A total of 83 fetuses/neonates were included, with a growing number of cases annually.
• All families engaged with the PG team, with 90% adopting comfort care plans.
• A significant shift in care goals from intensive treatment to palliative care was observed.

Conclusions:

• The significant growth of the PG service over 13 years highlights the essential need for PPC.
• Continuity of care facilitated parental decision-making, particularly in redirecting care goals.
• Observed outcomes offer valuable prognostic insights for improved future counseling.