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J Palliat Med. 2020 Jan 10. doi: 10.1089/jpm.2019.0651. [Epub ahead of print]

Top Ten Tips Palliative Care Clinicians Should Know About Caring for Serious Illness in Pregnancy.

Author information

1
Division of Gynecologic Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
2
Division of Maternal Fetal Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
3
Division of Hematology and Oncology, University of North Carolina, Chapel Hill, North Carolina.
4
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology and Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina.
5
Divisions of Pediatric Critical Care and Pediatric Palliative Care, Medical University of South Carolina, Charleston, South Carolina.
6
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology and Division of Palliative Care, Department of Internal Medicine, University of Colorado School of Medicine, Denver, Colorado.
7
Department of Radiation Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
8
Department of Medicine and the Palliative and Advanced Illness Research Center, University of Pennsylvania, Philadelphia, Pennsylvania.

Abstract

Palliative care (PC) teams are increasingly being called upon to provide care earlier and more remote from end of life. Because much of the field has grown out of hospice and geriatric care, most teams have little to no experience caring for pregnant women or their fetuses when serious or life-threatening illness strikes. This article, written by a team of oncologists (gynecologic, medical, and radiation) and PC providers, seeks to demystify the care of seriously ill pregnant women and their fetuses by exploring the diagnostic, treatment, prognostication, symptom management, and communication needs of these patients. Truly comprehensive PC extends throughout the life span, from conception to death, regardless of age. Accordingly, increased knowledge of the unique needs of these vulnerable groups will enhance our ability to provide care across this continuum.

KEYWORDS:

cancer treatment during pregnancy; nonpain symptom management; pain management during pregnancy; periviable infants; pregnant women with catastrophic injuries; serious illness in pregnancy

PMID:
31928374
DOI:
10.1089/jpm.2019.0651

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