EP06.31: Prenatal approach to perinatal palliative care: a maternal‐fetal vision

To describe the cases that required perinatal palliative care due to life-limiting fetal pathology and their approach process followed at the National Institute of Perinatology. A descriptive study. Included patients who entered the palliative care program between 2018 and 2022. The data collected included demographic information, prenatal diagnosis, the plan established by the interdisciplinary team, details of pregnancy resolution, hospital stay, type of discharge, and postnatal follow-up. Of 1757 patients, 198 patients were eligible to receive palliative care, and 11 were excluded because they continued their care at another institution. The remaining 187 patients were divided into two groups: 35 of them suffered stillbirth in the weeks after diagnosis and the parents received psychoemotional support for grief, while 152 patients were formally admitted to the palliative care clinic. The average maternal age was 27 years, and patients were admitted most frequently in the third trimester. 54 patients had a diagnosis of heart disease (35.52%) The average age of resolution was 35.6 weeks. Of the patients, 27 (18%) underwent pregnancy termination. The most frequent route of resolution was vaginal, with 85 patients (55.92%). No stillbirth occurred, the main destination was rooming in, and many died during the first day of extrauterine life. 110 were discharged due to death (72.36%) and the rest were discharged home. All patients attended a genetics appointment postpartum to receive information and advice based on established diagnoses and risks of recurrence. In the 5 years analysed, 152 patients received perinatal palliative care for fetal pathology, which represents a high number of patients compared to the world literature. However, it is still difficult to adapt all the precepts of palliative care to the prenatal stage in which the fetus is involved with a life-limiting illness and the parents are making decisions and going through grief. Fetal heart disease was identified as the leading cause of prenatal palliative care.