title: Lethal fetal abnormalities: how to approach perinatal palliative care?
abstract: OBJECTIVE
  Some of the antenatally diagnosed fetal pathologies are unlikely to get compatible with life. Still some women choose to continue with pregnancy. Subsequently, perinatal palliative care (PPC) has become a constructive demarche in such situations. Our study, based on a multicentric survey, reports some cases of fetal pathologies considered as lethal according to perinatal professionals and reveals the decisional process in each case.
  
  
  METHODS
  We sent by emails a questionnaire to 434 maternal-fetal medicine specialists and fetal care pediatric specialists at 48 multidisciplinary centers for prenatal diagnosis.
  
  
  RESULTS
  The participation rate was 49.3%. In total, 61 obstetric-gynecologists and 68 neonatologists completed the survey. The results showed that 35.4% of the pregnant women asked for the continuation of pregnancy and 24.7% asked for the termination of pregnancy. More than half of professionals (52.9%) took the initiative of informing women about the options for birth support (including PPC), while 32.7% of obstetric gynecologists did not take this initiative versus 10.2% of neonatologists (p  < 0.01).
  
  
  CONCLUSIONS
  This study demonstrates the absolute need to provide PPC training for professionals and to standardize its practices.
authors.affiliation: a Aix-Marseille University/EFS/CNRS, UMR 7268 ADÉS, Espace Éthique Méditerranéen, Hospital La Timone , Marseille , France and.|b Department of Neonatology , Assistance Publique-Hôpitaux De Marseille, Hospital Nord , Marseille , France.
authors.forename: Barthélémy
authors.initials: B
authors.lastname: Tosello
authors.affiliation: b Department of Neonatology , Assistance Publique-Hôpitaux De Marseille, Hospital Nord , Marseille , France.
authors.forename: Grace
authors.initials: G
authors.lastname: Haddad
authors.affiliation: b Department of Neonatology , Assistance Publique-Hôpitaux De Marseille, Hospital Nord , Marseille , France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Gire
authors.affiliation: a Aix-Marseille University/EFS/CNRS, UMR 7268 ADÉS, Espace Éthique Méditerranéen, Hospital La Timone , Marseille , France and.
authors.forename: Marie-Ange
authors.initials: MA
authors.lastname: Einaudi
mesh_terms: D001291:Attitude of Health Personnel; D005260:Female; D005333:Fetus / Q000002:abnormalities*; D006801:Humans; D007231:Infant, Newborn; D010166:Palliative Care / Q000458:organization & administration* / Q000523:psychology; D010290:Parents / Q000523:psychology*; D018743:Perinatal Care / Q000458:organization & administration*; D010817:Physician-Patient Relations; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011795:Surveys and Questionnaires
keywords: Ethical issue; fetal abnormality; information; palliative care; perinatal medicine