title: Feelings of women regarding end-of-life decision making after ultrasound diagnosis of a lethal fetal malformation.
abstract: OBJECTIVE
  this study investigated the feelings of women regarding end-of-life decision making after ultrasound diagnosis of a lethal fetal malformation. The aim of this study was to present the decision making process of women that chose for pregnancy termination and to present selected speeches of women about their feelings.
  
  
  METHODS
  open psychological interviews conducted by a psychologist immediately after the diagnosis of fetal malformation by ultrasound. Analysis of the results was performed through a content analysis technique.
  
  
  METHODS
  the study was carried out at a public university hospital in Brazil.
  
  
  METHODS
  249 pregnant women who had received the diagnosis of a severe lethal fetal malformation.
  
  
  RESULTS
  fetal anencephaly was the most frequent anomaly detected in 135 cases (54.3%). Termination of pregnancy was decided by 172 (69.1%) patients and legally authorised by the judiciary (66%). The reason for asking for termination was to reduce suffering in all of them. In the 77 women who chose not to terminate pregnancy (30.9%), the reasons were related to feelings of guilt (74%).
  
  
  CONCLUSIONS
  the results support the importance of psychological counselling for couples when lethal fetal malformation is diagnosed. The act of reviewing moral and cultural values and elements of the unconscious provides assurance in the decision-making process and mitigates the risk of emotional trauma and guilt that can continue long after the pregnancy is terminated.
authors.affiliation: Division of Psychology, Clinics Hospital of Faculty of Medicine, University of São Paulo, Av. Dr. Enéas de Carvalho Aguiar 255, 10th Floor, Suite 10037, CEP 05403-000, São Paulo, SP, Brazil. grguerra@uol.com.br
authors.forename: Gláucia R G
authors.initials: GR
authors.lastname: Benute
authors.forename: Roseli M Y
authors.initials: RM
authors.lastname: Nomura
authors.forename: Adolfo W
authors.initials: AW
authors.lastname: Liao
authors.forename: Maria de Lourdes
authors.initials: Mde L
authors.lastname: Brizot
authors.forename: Mara C S
authors.initials: MC
authors.lastname: de Lucia
authors.forename: M
authors.initials: M
authors.lastname: Zugaib
mesh_terms: D000025:Abortion, Eugenic / Q000523:psychology*; D000223:Adaptation, Psychological; D000328:Adult; D001938:Brazil; D000013:Congenital Abnormalities / Q000000981:diagnostic imaging / Q000523:psychology*; D005260:Female; D006801:Humans; D009035:Mothers / Q000523:psychology*; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D009769:Object Attachment; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology*; D012944:Social Support; D016216:Ultrasonography, Prenatal / Q000523:psychology; D055815:Young Adult