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Referrals to a perinatal specialist palliative care consult service in Ireland, 2012-2015
- Source :
- Archives of disease in childhood. Fetal and neonatal edition. 103(6)
- Publication Year :
- 2017
-
Abstract
- ObjectiveTo analyse the referral patterns of perinatal patients referred to a specialist palliative care service (SPCS), their demographics, diagnoses, duration of illness, place of death and symptom profile.DesignA retrospective chart review of all perinatal referrals over a 4-year period to the end of 2015.SettingA consultant-led paediatric SPCS at Our Lady’s Children’s Hospital, Crumlin, Dublin, and the Coombe Women & Infants University Hospital, Dublin.Results83 perinatal referrals were received in a 4-year period. Chromosomal abnormalities accounted for 35% of diagnoses, congenital heart disease 25%, complex neurological abnormalities 11% and renal agenesis 4%. 22 referrals (26.5%) were made antenatally, with 61 (73.5%) postnatally. Of the postnatal referrals, 27 (44%) were asymptomatic on referral. An opioid medication was recommended (regularly or as required) in 46 cases. Symptom control was achieved without dose titration in 43 of these cases (93%). Of 47 deaths in this group referred postnatally, 22 of these (47%) died at home with support from community teams. Discharge home for best supportive care required complex interagency communication and cooperation.ConclusionsPerinatal palliative care requires effective multidisciplinary work, whether delivered in the inpatient setting or in the community. With appropriate support, end-of-life care can be delivered in the community.
- Subjects :
- Male
medicine.medical_specialty
Pediatrics
Palliative care
Referral
Heart disease
Asymptomatic
03 medical and health sciences
0302 clinical medicine
Pregnancy
030225 pediatrics
medicine
Humans
030212 general & internal medicine
Neonatology
Medical diagnosis
Referral and Consultation
Retrospective Studies
business.industry
Palliative Care
Obstetrics and Gynecology
Retrospective cohort study
General Medicine
medicine.disease
Perinatal Care
Pediatrics, Perinatology and Child Health
Emergency medicine
Female
medicine.symptom
business
Ireland
Subjects
Details
- ISSN :
- 14682052
- Volume :
- 103
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Archives of disease in childhood. Fetal and neonatal edition
- Accession number :
- edsair.doi.dedup.....9a320723510e47a837c3def80e2ca260