Preferred prenatal counselling at the limits of viability: a survey among Dutch perinatal professionals

Ms Rosa Geurtzen*, Arno Van Heijst, Rosella Hermens, Hubertina Scheepers, Mallory Woiski, Jos Draaisma, Marije Hogeveen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

15 Citations (Web of Science)

Abstract

Background: Since 2010, intensive care can be offered in the Netherlands at 24(+0) weeks gestation (with parental consent) but the Dutch guideline lacks recommendations on organization, content and preferred decision-making of the counselling. Our aim is to explore preferred prenatal counselling at the limits of viability by Dutch perinatal professionals and compare this to current care. Methods: Online nationwide survey as part of the PreCo study (2013) amongst obstetricians and neonatologists in all Dutch level III perinatal care centers (n = 205). The survey regarded prenatal counselling at the limits of viability and focused on the domains of organization, content and decision-making in both current and preferred practice. Results: One hundred twenty-two surveys were returned out of 205 eligible professionals (response rate 60%). Organization-wise: more than 80% of all professionals preferred (but currently missed) having protocols for several aspects of counselling, joint counselling by both neonatologist and obstetrician, and the use of supportive materials. Most professionals preferred using national or local data (70%) on outcome statistics for the counselling content, in contrast to the international statistics currently used (74%). Current decisions on initiation care were mostly made together (in 99% parents and doctor). This shared decision model was preferred by 95% of the professionals. Conclusions: Dutch perinatal professionals would prefer more protocolized counselling, joint counselling, supportive material and local outcome statistics. Further studies on both barriers to perform adequate counselling, as well as on Dutch outcome statistics and parents' opinions are needed in order to develop a national framework.
Original languageEnglish
Article number7
Number of pages8
JournalBMC Pregnancy and Childbirth
Volume18
DOIs
Publication statusPublished - 3 Jan 2018

Keywords

  • Decision-making
  • (extreme) prematurity
  • (limits of) viability
  • EXTREMELY PREMATURE-INFANTS
  • EXTREMELY PRETERM BIRTH
  • DECISION-MAKING
  • EXTREME PREMATURITY
  • INTENSIVE-CARE
  • HIGH-RISK
  • PARENTS
  • THRESHOLD
  • DELIVERY
  • MANAGEMENT
  • Humans
  • Middle Aged
  • Patient Participation
  • Neonatology
  • Perinatal Care
  • Male
  • Directive Counseling/methods
  • Netherlands
  • Adult
  • Female
  • Surveys and Questionnaires
  • Decision Making
  • Attitude of Health Personnel
  • Patient Education as Topic/methods
  • Gestational Age
  • Obstetrics
  • Pregnancy
  • Premature Birth/physiopathology

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