Poster Session

P80. Ethical Dilemmas Regarding Pre- And Perinatal Mortality In Hungary

Eva Zsak (HU)

[Zsak] Semmelweis University

Context: Losing a child in the pre- and perinatal period is a highly demanding event for both families and health care professionals as well. While in 2015 the statistical number of perinatal death is relatively low (0.65%), the total number of babies lost in perinatal mortality was 553, yet, the burden it conveys is all the bigger. Objectives: (1) Present the current health care system with the services provided for the families facing child loss. (2) Highlight the ethical problems, challenges for the health care professionals when facing perinatal mortality. Interventions: Study and comparison of the presently approved Hungarian protocol and institutional practices in obstetrics and gynaecology and neonatology departments (ob-gyn departments nationwide, 7 PICs at 4 university clinics, interviewed 36 health care specialists (5 department heads, 12 doctors, 7 mid-wives, 10 nurses, 2 psychologists) ) concerning pre- and perinatal child loss and support for the bereaved families. Main Outcome: The comparison of the valid protocol with the actual practices and needs these events convey in the already visited departments reveals the lack of proper knowledge of the protocol in approx. 60% of the institutions and its scarce application in the rest. Results: The professional and personal requirements pre- and perinatal care specialists must meet show that while there is a growing need for individualised care and despite the existing legislative and protocol measures, the mindset of the healthcare professionals can slowly be changed and specific trainings are also necessary in the formation processes. Significant differences can also be observed between the institutions, regarding the application of the legal measures and applying own institutional procedures, protocols for treatment of the corpses and bereavement care. Conclusions: For proper care regarding pre- and perinatal loss in Hungarian institutions a shift of attitude is needed in the competency fields of the professional as much as the established cooperation of a multidisciplinary group. It requires new protocols, trainings, supportive and psychological measures.