Quiz 1: Introduction to perinatal palliative care

Please choose the one, most correct answer to each question or statement.

1. What is the working definition of the perinatal period when perinatal palliative care is given?
   • From when pregnancy is confirmed to 28 days after delivery
   • From 22 weeks of gestation until delivery
   • From birth to 3 months of age
   • At any time during pregnancy and the first year of the child’s life
2. What is the extended definition of perinatal death?
   • Any death from 20 weeks of gestation to 28 days after delivery
   • Any death from 22 weeks of gestation until 28 days after delivery
   • Any death between 28 weeks of gestation and 7 days after delivery
   • Any death from the time of birth until the baby is discharged home
3. Liveborn babies who die before 28 days after delivery are recorded as:
   • Preterm infants
   • A miscarriage
   • A neonatal death
   • An early neonatal death
4. Perinatal palliative care provides:
   • Holistic, multidisciplinary support for families following the diagnosis or recognition of a life-limiting condition of the fetus or newborn infant
   • Clinical care for babies born before 20 weeks
   • Care for newborn babies only
   • Care for babies diagnosed with congenital disorders during pregnancy only
5. The Together for Short Lives’ definition of perinatal palliative care includes which of the following statements?
   • Caring for the unborn baby holistically
   • Embraces the physical, emotional, social, and spiritual elements and focuses on the enhancement of quality of life for the neonatal infant and support for the family
   • Prolonging life by improving the quality of life of the newborn baby
   • Is provided in the same manner as children and adult palliative care
6. When does grieving start?
   • At the time of hearing the bad news of the health or prognosis of their baby
   • When the baby is born and can be seen by the parents
   • Once the baby has died after delivery
   • Between one day and one week after the baby’s death
7. Perinatal palliative care aims to:
   • Care for babies who are dying only
   • Care for families whose baby has died in utero only
   • Prevent the baby from being admitted to a neonatal intensive care unit
   • To relieve suffering, to preserve dignity and promote quality of life for the baby and the family
8. Perinatal palliative care is important because it:
   • Honours the parental wishes and preferences for their baby’s care
   • Decides for the family that a termination would be in their best interest if the baby is diagnosed with a life-limiting condition in utero
   • Looks after the doctor and nurses
   • Can cure the condition
9. Referral to a perinatal palliative care team can be made:
   • From 12 weeks
   • At any point from diagnosis of a life-limiting fetal condition
   • Only after delivery and the baby is found to have a fetal abnormality
   • By a neonatologist or obstetrician only
10. In which situations should perinatal palliative care be provided?
    • For miscarriage and stillbirth only
    • When there is a stillbirth before 26 weeks only
    • If a baby weighs less than 500 grams at birth
    • For perinatal loss, confirmed and potential life-limiting conditions, and life-threatening conditions
11. A life-limiting condition is one that:
    • Can be cured immediately if treated correctly
    • Is life-threatening if not treated immediately
    • Is a condition that is expected to result in an early death
    • Needs care and support at the end of life only
12. According to the British Association of Perinatal Medicine (BAMP), classification conditions that are not compatible with long term survival e.g. bilateral renal agenesis or anencephaly fall into which category?
    • Category 1
    • Category 2
    • Category 3
    • Category 4
13. Which one of the following is considered to fall into Category 3 of life-threatening conditions?
    • Postnatal conditions which result in the baby experiencing ‘unbearable suffering’ in the course of their illness or treatment, e.g. severe necrotizing enterocolitis
    • Postnatal clinical conditions with a high risk of severe impairment of quality of life and when the baby is receiving life support or may at some point require life support, e.g. severe hypoxic ischemic encephalopathy (HIE)
    • Babies born at the margins of viability, where it has been decided not to offer intensive care
    • A diagnosis which has a high risk of significant morbidity or mortality, e.g. severe bilateral hydronephrosis and hydrocephaly
14. What is a continuum of care?
    • The support the family receive once the baby is born alive until they are discharged
    • The support the family receive once the baby has died
    • The care that is provided once the disease or condition cannot be treated anymore
    • The compassionate, non-judgemental integrated care, which is provided in an ongoing fashion, regardless of the setting, from time of diagnosis
15. Perinatal palliative care requires a collaborative team approach with which of the following team members?
    • A neonatologist doctor, paediatric nurse and social worker only
    • Both core (e.g. doctors, nurses, social workers and spiritual workers) and extended team members (e.g. sonographers, psychologists, bereavement doulas and genetic counsellors) and includes the parents
    • A specialist palliative care team only
    • A paediatrician, nurse and spiritual worker
16. Where can perinatal palliative care be provided?
    • In a tertiary hospital only
    • In a hospice by the palliative care team
    • In a neonatal intensive care unit where there is a team of paediatric specialists
    • These settings may include clinics, maternity wards, neonatal units, or nursery areas and in the home
17. Perinatal palliative care can be provided in which of the following periods?
    • Antenatal, intrapartum and postnatal periods
    • Antenatal period only
    • Intrapartum period only
    • Postnatal period only
18. Bereavement care and support needs to be offered in which period?
    • From the intrapartum period to the postpartum period
    • From the diagnosis of a life-limiting condition into the postnatal period
    • Once the baby has died
    • In the postnatal period only
19. Can palliative care and medical treatment be provided together?
    • No
    • Yes, but only during pregnancy
    • Yes, but only after delivery
    • Yes
20. What is a core element when providing palliative care?
    • Creating goals of care which includes birth planning
    • Providing good clinical care during pregnancy
    • Helping the parents pay for the hospital care
    • Hiring a doula (birth support) during labour