Feelings of women regarding end-of-life decision making after ultrasound diagnosis of a lethal fetal malformation

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• 作者：Gl¨¢ucia R.G. Benute ; Roseli M.Y. Nomura ; Adolfo W. Liao ; Maria de Lourdes Brizot ; Mara C.S. de Lucia ; M. Zugaib
• 关键词：Fetal abnormality ; Abortion ; Guilt ; Pregnancy
• 刊名：Midwifery
• 出版年：2012
• 出版时间：August, 2012
• 年：2012
• 卷：28
• 期：4
• 页码：472-475
• 全文大小：127 K

文摘

lass=""h4"">Objective

this study investigated the feelings of women regarding end-of-life decision making after ultrasound diagnosis of a lethal fetal malformation. The aim of this study was to present the decision making process of women that chose for pregnancy termination and to present selected speeches of women about their feelings.

lass=""h4"">Design

open psychological interviews conducted by a psychologist immediately after the diagnosis of fetal malformation by ultrasound. Analysis of the results was performed through a content analysis technique.

lass=""h4"">Setting

the study was carried out at a public university hospital in Brazil.

lass=""h4"">Participants

249 pregnant women who had received the diagnosis of a severe lethal fetal malformation.

lass=""h4"">Findings

fetal anencephaly was the most frequent anomaly detected in 135 cases (54.3 % ). Termination of pregnancy was decided by 172 (69.1 % ) patients and legally authorised by the judiciary (66 % ). The reason for asking for termination was to reduce suffering in all of them. In the 77 women who chose not to terminate pregnancy (30.9 % ), the reasons were related to feelings of guilt (74 % ).

lass=""h4"">Key conclusions

the results support the importance of psychological counselling for couples when lethal fetal malformation is diagnosed. The act of reviewing moral and cultural values and elements of the unconscious provides assurance in the decision-making process and mitigates the risk of emotional trauma and guilt that can continue long after the pregnancy is terminated.