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Palliative Care in Obstetrics and Gynecology

Lefkowits, Carolyn MD, MPH; Solomon, Caroline MD

doi: 10.1097/AOG.0000000000001739
Contents: Clinical Expert Series
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Palliative care is specialized care for people with life-limiting illness; it focuses on symptom management and quality of life and ensures that a patient's care is concordant with her goals and values. Unlike end-of-life care, palliative care can be offered concurrently with disease-directed therapies, including when the goal is cure. Obstetrics and gynecology patients for whom palliative care is most appropriate include women with gynecologic cancer and women with a fetus or neonate with a potentially life-limiting illness. Integration of palliative care for these patients offers both clinical and health care utilization benefits, including improved symptom management, improved quality of life, and high-value care. Palliative care can be provided by palliative care specialists (specialty palliative care) or by the team treating the life-limiting illness (primary palliative care), depending on the complexity of the need. Health care providers caring for patients with life-limiting illness, including obstetrician–gynecologists, must possess a basic primary palliative care skill set, including symptom management for common symptoms such as pain and nausea and communication skills such as breaking bad news. This skill set must be taught and evaluated during training and used consistently in practice to ensure that our patients receive truly comprehensive care.

Supplemental Digital Content is Available in the Text.Palliative care adds quality and value to the care of the obstetric or gynecologic patient with serious illness in herself, her fetus, or her neonate.

Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, and the Department of Internal Medicine, Division of General Internal Medicine, Palliative Care Service, University of Colorado Denver School of Medicine, Aurora, Colorado; and the Departments of Obstetrics and Gynecology, Olive View–UCLA Medical Center, Sylmar, and Southern California Kaiser Permanente Medical Group, Panorama City, California.

Corresponding author: Carolyn Lefkowits, MD, MPH, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Mail Stop B198-4 Academic Office 1, 12631 E 17th Avenue, Room 4411, Aurora, CO 80045; e-mail: carolyn.lefkowits@ucdenver.edu.

Financial Disclosure The authors did not report any potential conflicts of interest.

Continuing medical education for this article is available at http://links.lww.com/AOG/A882.

© 2016 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.