20 June 2019

In Pediatrics Rosa Geurtzen, Marije Hogeveen et al described the development of a nationwide, evidence-based framework for prenatal counseling in extreme prematurity using a RAND-modified Delphi method, involving parents, obstetricians and neonatologists as experts.

Recommendations on organization, decision-making, content, and style of prenatal counseling were included in the framework, including tools to support personalization. The most important recommendations regarding organization were to have both parents involved in the counseling with both the neonatologist and obstetrician. The shared decision-making model was recommended for deciding between active support and comfort care. Main recommendations regarding content of conversation were explanation of treatment options, information on survival, risk of permanent consequences, impossibility to predict an individual course, possibility for multiple future decision moments, and a discussion on parental values and standards. The national professional associations (gynecology and pediatrics) and patient organization approved the framework, the Dutch version can be found here.

Article in Pediatrics
Development of Nationwide Recommendations to Support Prenatal Counseling in Extreme Prematurity.
Geurtzen R, van Heijst AFJ, Draaisma JMT, Kuijpers LJMK, Woiski M, Scheepers HCJ, van Kaam AH, Oudijk MA, Lafeber HN, Bax CJ, Koper JF, Duin LK, van der Hoeven MA, Kornelisse RF, Duvekot JJ, Andriessen P, van Runnard Heimel PJ, van der Heide-Jalving M, Bekker MN, Mulder-de Tollenaer SM, van Eyck J, Eshuis-Peters E, Graatsma M, Hermens RPMG, Hogeveen M.

Rosa Geurtzen is member of theme Healthcare improvement science.
 

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