Improving Neonatal-Parental Counseling During Periviable Period
Peter Murray, MD, discusses developing a checklist for advising parents in the periviable period
Peter Murray, MD: Hi, my name is Peter Murray and I am an attending neonatologist here at UVA Health Children's. I also serve as co-chair of the ethics committee for UVA Health.
As part of the Investigating Neonatal Decisions for Extremely Early Delivery study group, I was able to participate in a very long study with the ultimate goal of coming up with a checklist that would be used for those neonatologists and neonatology fellows who are participating in counseling of women and families who present at risk for preterm birth in the periviable period.
Having a reliable checklist and a reliable way to enter into antenatal consultation is crucial. The gestational age at which we perform resuscitation is already lowered down to 22 weeks of gestation. And I think we have to have a very concrete approach to consultation so that the family can make the best decision for their family.
If we don't do that, we run the risk of having a violation of the principle of justice because families might enter into one consultation with provider A versus provider B and be told a completely different outcome expectation and that is not appropriate.
The second group of people who will benefit from this checklist are, of course, those who are still in training. So we hope that our checklist can act as a bridge towards better consultations in the antenatal period for those who are still in training and can be used by more seasoned and senior attendings such as myself to teach the next generation of neonatologists how to perform antenatal consultation well.
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