Diagnosis of Fetal Anomaly and the Increased Maternal Psychological Toll Associated with Pregnancy Termination.

Approximately 4% of U.S. abortions occur in desired pregnancies, with many resulting from fetal anomalies. The majority of terminations occur in the second trimester; however in recent years first-trimester ultra sound measurement for nuchal translucency, calculation of risk based on maternal age, a...

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Publicado en:Issues in Law & Medicine Vol. 30; no. 1; pp. 3 - 24
Autor principal: Coleman, Priscilla K.
Formato: review Journal Article
Publicado: Issues in Law & Medicine Spring2015
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Issues in Law & Medicine
      place: Terre Haute, Indiana
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        atl: Diagnosis of Fetal Anomaly and the Increased Maternal Psychological Toll Associated with Pregnancy Termination.
      aug:
        au: Coleman, Priscilla K.
        affil: Professor of Human Development and Family Studies, Bowling Green State University
      sug:
        subj:
          Congenital, Hereditary, and Neonatal Diseases and Abnormalities Diagnosis
          Prenatal Diagnosis
          Abortion, Induced Psychosocial Factors
          Perinatal Care Methods
          Hospice Care Methods
          Abortion, Induced Statistics and Numerical Data
          Culture
          Bereavement
          Decision Making
          Fear Prevention and Control
      ab: Approximately 4% of U.S. abortions occur in desired pregnancies, with many resulting from fetal anomalies. The majority of terminations occur in the second trimester; however in recent years first-trimester ultra sound measurement for nuchal translucency, calculation of risk based on maternal age, and biochemistry at 11-14 weeks gestation, have resulted in earlier prenatal diagnoses for chromosomal abnormalities. First trimester ultrasound can also now lead to diagnoses of major structural abnormalities including anecephaly, ventral wall defects, and limb abnormalities. The American College of Medical Genetics released recommendations underscoring the crucial importance of ethical counseling and substantive communication with parents facing a prenatal diagnosis of fetal anomaly. Unfortunately, the inability of health care providers to understand and empathize with the ardent desire of some parents to refuse termination is likely to be a large factor in the common practice of professionals attempting to steer expectant parents toward termination. Perinatal hospice is family-centered, comprehensive, and integrative in nature. The care provided by perinatal hospice units is delivered by an interdisciplinary team of obstetricians, pediatricians, nurses, social work ers and chaplains in 130 locations throughout the U.S. Support is offered from diagnosis until death and beyond with time for “bonding, loving, and losing.” “Hospice care is an interactive, and at times intense, form of care. Rather than simply ‘letting nature take its course,' this approach empowers the family to take control of some of the consequences of their unfortunate situation.” A primary focus of perinatal hospice is on fear reduction. Parents facing the death of an infant often fear isolation and abandonment in addition to worrying about their child experiencing pain. Parents are assured that they will be cared for and supported throughout this entire chapter of their lives, as their babies are kept comfortable and free of pain until death. The approach is realistic without shattering hope that the diagnosis was wrong or that a miracle will take place as there is recognition that hope keeps parents going. There is also recognition that building memories is essential to the grieving process and frequent use of ultrasound is designed to provide visualization experience. Perinatal hospice teams assist in the development of birth plans, address the type and location of the delivery as well as aftercare of the mother and infant.
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    language: English
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