Extending the Concept of Advance Care Planning to the Perinatal Period

Abstract

Easier access to prenatal diagnostic procedures led to its widespread use as a screening measure. Hence, today it is more common for life-limiting illnesses to be diagnosed during fetal life. The concept of Advance Care Planning (ACP) provides a framework for caregivers, families and their multidisciplinary teams to anticipate and plan ahead for potential future medical decisions so that the affected children are reliably treated according to their parents’ individual values and wishes. In the perinatal context, ACP also has the potential to tackle the needs of unborn or newborn children with life-limiting illnesses and their families better, avoid unnecessary and burdensome measures and focus upon goals that are valuable and meaningful to both child and family.

Zusammenfassung

Eine einfach zugängliche und hoch technisierte Schwangerenvorsorge hat die Anzahl von feindiagnostischen Maßnahmen deutlich zunehmen lassen. Dies hat dazu geführt, dass lebensverkürzende Erkrankungen immer häufiger schon in der Fetalzeit diagnostiziert werden. Die Ausweitung des Konzeptes von Advance Care Planning (ACP) in die Perinatologie bietet die Möglichkeit, zukünftige (Be-)Handlungsschritte mit der Schwangeren bzw. den Eltern vor und nach der Geburt unter Berücksichtigung sowohl medizinischer als auch nichtmedizinischer Aspekte individuell für verschiedene Phasen der Schwangerschaft, der Geburt und des kindlichen Krankheitsverlaufes zu planen. Ein angemessenes und rechtzeitiges Advance Care Planning hat somit das Potential, eine Verbesserung der Versorgung von ungeborenen bzw. neugeborenen Kindern mit lebensverkürzenden Erkrankungen und ihren Familien zu erreichen, unnötige und belastende Maßnahmen für betroffene Kinder zu vermeiden und den Fokus auf Ziele zu legen, die für Kind und Familie wertvoll und bedeutsam sind.

Key words

neonate - pregnancy - life-limiting disease - palliative care - birth plan - prenatal counselling

Schlüsselwörter

Neugeborene - Schwangerschaft - lebensverkürzende Erkrankung - Palliativmedizin - Geburtsplan - Pränatalberatung

Publication History

Article published online:
15 June 2020

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