[Very preterm births (22-26 WG): from the decision to the implement of palliative care in the delivery room. Experience of Rennes University Hospital (France)].
OBJECTIVE
After the establishment of a palliative care protocol (PC) in the delivery room, study how the postnatal management decision was taken and in particular how PC was developed.


METHODS
Retrospective analysis of births between 22 and 25+6 WG, in Rennes University Hospital, during 21 months.


RESULTS
Twenty-seven women meeting the criteria gave birth to 32 live children. Decision making (intensive care or PC) was fast but shared with the parents, mainly on the criterion of the term. The delivery was vaginal for 24 children. Thirteen children were resuscitated. Nineteen children received comfort care, their life was less than 3 hours, 18/19 were supported by their parents.


CONCLUSIONS
The management of these births is consistent with current recommendations, decisions are individualized but often informally. The secondary prognostic criteria could be better taken into account. Obstetrical and pediatric management is consistent. The PC protocol is fairly well used but the collective decisions should be more formally organized and transcribed more accurately in the records, the requirements for analgesics should be based on clinical assessments.
Service d'obstétrique, hôpital Sud, CHU, BP 90347, 16 boulevard de Bulgarie, Rennes cedex 2, France. anne-sophie.cabaret@chu-rennes.fr
A-S
AS
Cabaret
F
F
Charlot
G
G
Le Bouar
P
P
Poulain
P
P
Bétrémieux
D005260:Female; D005602:France; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D015931:Intensive Care, Neonatal / Q000523:psychology; D010166:Palliative Care / Q000523:psychology; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies