Caring for the pregnant woman presenting at periviable gestation: acknowledging the ambiguity and uncertainty.
Counseling the periviable pregnant woman presenting at the edge of viability can often be confusing for the patient and frustrating for the clinician. Although neonatal survival rates have improved dramatically over the last few decades, severe morbidity is still common. This is further complicated by the fact that the information provided to the parents regarding the outcomes may not be up to date or completely accurate. The counseling is also frequently influenced by personal beliefs and biases of the medical staff. An evidence-based approach may improve the experience for both the expectant parents and the health care team.
Tomlinson
Mark W
MW
Departments of Obstetrics and Gynecology and Neonatology, Providence St. Vincent Medical Center, Portland, OR, USA. mwtomlinson@comcast.net
Kaempf
Joseph W
JW
Ferguson
Linda A
LA
Stewart
Valerie T
VT
D003657:Decision Making; D019317:Evidence-Based Medicine; D005260:Female; D005328:Fetal Viability / Q000502:physiology*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D015931:Intensive Care, Neonatal; D010817:Physician-Patient Relations; D011247:Pregnancy; D035501:Uncertainty