Comparing obstetricians' and neonatologists' approaches to periviable counseling

B. Tucker Edmonds, F. Mckenzie, J. E. Panoch, A. E. Barnato, R. M. Frankel

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Objective:To compare the management options, risks and thematic content that obstetricians and neonatologists discuss in periviable counseling.Study Design:Sixteen obstetricians and 15 neonatologists counseled simulated patients portraying a pregnant woman with ruptured membranes at 23 weeks of gestation. Transcripts from video-recorded encounters were qualitatively and quantitatively analyzed for informational content and decision-making themes.Result:Obstetricians more frequently discussed antibiotics (P=0.005), maternal risks (<0.001) and cesarean risks (<0.005). Neonatologists more frequently discussed neonatal complications (P=0.044), resuscitation (P=0.015) and palliative options (P=0.023). Obstetricians and neonatologists often deferred questions about steroid administration to the other specialty. Both specialties organized decision making around medical information, survival, quality of life, time and support. Neonatologists also introduced themes of values, comfort or suffering, and uncertainty.Conclusion:Obstetricians and neonatologists provided complementary counseling content to patients, yet neither specialty took ownership of steroid discussions. Joint counseling and/or family meetings may minimize observed redundancy and inconsistencies in counseling.

Original languageEnglish (US)
Pages (from-to)344-348
Number of pages5
JournalJournal of Perinatology
Volume35
Issue number5
DOIs
StatePublished - May 30 2015

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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