(HealthDay News) − Obstetric decisions in managing and counseling for periviable deliveries are heavily influenced by patient preference and perspectives on patient autonomy.
To examine factors influencing obstetric decision-making and counseling for patients with high-risk periviable neonates, Brownsyne Tucker Edmonds, MD, MPH, of the University of Pennsylvania in Philadelphia, and associates conducted 21 in-depth interviews with obstetricians from several Philadelphia hospitals that offer labor and delivery services.
The researchers found that patient preferences had a strong influence on obstetric decision-making and counseling. They further discovered that most institutions had no formal clinical standards for periviable care or managing premature deliveries between 22−26 weeks, which resulted in a wide variation in practices.
“The impact of institutional variation and in vitro fertilization on periviable decision-making warrants further consideration,” the authors write. “Interventions to train and support obstetricians in communicating uncertainty, managing expectations, and assessing values and understanding are needed.”