Key practical aspects of perinatal palliative care: a scoping review mapping and grading their coverage in the...

Despite growing recognition of the importance of perinatal palliative care (PnPC) as a comprehensive approach to supporting seriously ill fetuses or neonates and their families, its implementation in clinical practice remains nascent and heterogeneous. A synthesis of the literature may clarify which aspects are being addressed and how they are operationalized. We aimed to map how the key practical aspects (KPAs) of PnPC are reported in the literature and to assess the level of detail with which they are described.

We conducted a scoping review of PubMed in May 2025. We included articles that described, analyzed, or conceptualized practical aspects of PnPC programs or dedicated units. Following independent screening, 137 articles were included. We developed a KPA coding framework informed by landmark publications and guideline documents, and rated the depth of coverage for each KPA as 0 (not mentioned), 1 (mentioned), or 2 (discussed).

The proposed KPA coding framework comprised 42 items across seven domains. The most frequently mentioned KPAs included the composition and competencies of the interdisciplinary core team (80% of included articles), patient- and family-centered care, and support for memory-making practices. However, substantial variability was observed in the depth of coverage across KPAs. Patient- and family-centered care and shared decision-making were the most consistently discussed in depth (≥ 25% of articles). In contrast, internal organizational processes-including emotional support for healthcare professionals (14%), continuous quality-improvement systems (14%), and release from other clinical responsibilities during the dying process (1%)-were infrequently reported and rarely examined analytically. The role of the extended interdisciplinary team was discussed with limited depth compared with that of the core team.

The PnPC literature appears more developed in relational and family-centered approaches and in defining the interdisciplinary core team. However, the formalization of organizational processes, structured support for healthcare professionals, and system-level consolidation remain limited. These findings suggest that current priorities should focus less on identifying new care components and more on organizing already recognized elements into standardized, evaluable structures, including internal coordination processes, team support mechanisms, and the systematic integration of psychological, social, and spiritual dimensions of care.