Knowledge and practices of Pediatricians regarding perinatal care in children with malformations with a poor prognosis

Abstract

Introduction: Neonatal comfort care is the palliative and supportive care provided to infants who are born with very low chances of life and who die within hours or a few days of birth, to soften or mitigate pain and to improve the quality of life in these patients. Objective: To identify the knowledge and practices of pediatricians regarding perinatal care in children with malformations with a poor prognosis. Materials and Methods: This was an observational, descriptive and cross-sectional study. An anonymous survey with close-ended questions was given to Pediatricians at the Maternal and Child Health Center of the School of Medicine's Clinicas Hospital in San Lorenzo and the Barrio Obrero General Hospital, which belongs to the Ministry of Public Health and Social Welfare. Results: 106 surveys were analyzed; 89 (84%) pediatricians do not recommend abortions to a pregnant woman whose child will be born with malformations incompatible with life. 16% (17) recommend abortions in those cases to avoid the suffering of the parents and because of the quality of life that these babies would have. In the case of newborns who do not breathe at birth, 93 (88%) pediatricians decide not to provide resuscitation, 85 (80%) pediatricians are not aware of the existence of a protocol to manage these newborns, and only 21 (20%) know about neonatal comfort care. Conclusions: Most pediatricians are not aware of the existence of a protocol to manage these newborns, and use their own criteria. The usual decision when faced with a newborn that did not attempt to breathe at birth was to not resuscitate. Most pediatricians would not recommend an abortion to a pregnant woman whose child will be born with malformations incompatible with life.