Perinatal grief following neonatal comfort care for lethal fetal condition

Article type: Research Article

Authors: Depoers-Béal, C.^a | Le Baccon, F.A.^a | Le Bouar, G.^a | Proisy, M.^b | Arnaud, A.^c | Legendre, G.^d | Dayan, J.^e | Bétrémieux, P.^f | Le Lous, M.^{a; *}

Affiliations: [a] Department of Obstetrics and Gynecology, University Hospital of Rennes, Rennes, France | [b] Department of Radiology, University Hospital of Rennes, Rennes, France | [c] Department of Pediatric Surgery, University Hospital of Rennes, Rennes, France | [d] Department of Obstetrics and Gynecology, University Hospital of Angers, Angers, France | [e] Department of Psychiatry, University Hospital of Rennes, Rennes, France | [f] Department of Pediatrics, University Hospital of Rennes, Rennes, France

Correspondence: [*] Address for correspondence: Maela Le Lous, MD, Department de Gynecology, Obstetrics and Reproductive Medicine, University Hospital of Rennes, 16 Bd de Bulgarie, BP 90347, F-35 203 Rennes Cedex 2, France. Tel.: +33 6 95 02 38 05; Fax: +33 2 99 26 67 40; E-mail: maela.le.lous@chu-rennes.fr

Abstract: BACKGROUND:The objective of the study was to assess perinatal grief experienced after continuing pregnancy and comfort care in women diagnosed with lethal fetal condition compared with termination of pregnancy for fetal anomaly (TOPFA). METHODS:This was a retrospective observational study which included women who chose to continue their pregnancy after the diagnosis of lethal fetal condition with comfort care support at birth at the Prenatal Diagnosis Center of Rennes Hospital from January 2007 to January 2017. Women were matched with controls who underwent TOPFA for the same type of fetal anomaly, gestational age at diagnosis and year. Women were evaluated by a questionnaire including the Perinatal Grief Scale. RESULTS:There were 28 patients in the continuing pregnancy group matched with 56 patients in the TOPFA group. Interval between fetal loss and completion of questionnaire was 6±3 years. Perinatal grief score was similar at 61±22 vs 58±18 (p = 0.729) in the continuing pregnancy and TOPFA groups, respectively. Women in the TOPFA group expressed more guilt. The cesarean-section rate in the continuing pregnancy group was 25%. CONCLUSION:Perinatal grief experienced by women opting for continuing pregnancy and comfort care after diagnosis of a potentially lethal fetal anomaly is not more severe than for those choosing TOPFA.

Keywords: Perinatal grief, continuing pregnancy and comfort care, termination of pregnancy, fetal anomaly

DOI: 10.3233/NPM-180180

Journal: Journal of Neonatal-Perinatal Medicine, vol. 12, no. 4, pp. 457-464, 2019