Medications to manage infant pain, distress and end-of-life symptoms in the immediate postpartum period

Expert Opin Pharmacother. 2022 Jan;23(1):43-48. doi: 10.1080/14656566.2021.1965574. Epub 2021 Aug 18.

Abstract

Introduction: Perinatal palliative care (PnPC) is a growing field where healthcare providers from multiple disciplines are supporting families and providing holistic care for their babies with life-limiting illnesses. It is important to have an approach that includes the standardized management of end-of-life symptoms that are anticipated around the time of birth.

Areas covered: A need was identified to develop medication orders for the initial pharmacological management of symptoms at end-of-life for infants with life-limiting conditions intended for use outside of an intensive care setting. The choice of medications was based on a review of the literature, discussion with content experts and guided by their ease of use, accessibility and noninvasive route of delivery. The recommendations can be used as a guide for the initial management of common symptoms encountered in perinatal palliative care.

Expert opinion: There are studies looking at many qualitative aspects of perinatal palliative care including perceptions of care, decision-making, and bereavement; however, few specifically focus on symptom management in the delivery room and postpartum ward settings. There is a need for standardization of the medical management of infants born with life-limiting conditions whose parents choose to pursue palliative care.

Keywords: Comfort care; life-limiting condition; medications; palliative care; perinatal palliative care; symptom management.

Publication types

  • Review

MeSH terms

  • Death
  • Female
  • Humans
  • Infant
  • Pain
  • Palliative Care*
  • Parents*
  • Postpartum Period
  • Pregnancy