Perinatal palliative care in a patient with antenatal fetal death due to severe preeclampsia with placental abruption.

A 37-year-old nulliparous woman was admitted to the hospital for mild bleeding. Intrauterine fetal death and placental abruption were diagnosed. The patient had a severe form of preeclampsia associated with fetal growth restriction and anuric renal failure. The delivery was associated with significant blood loss. Immediately after the termination of pregnancy by emergency caesarean section, the patient's condition required hospitalization in the intensive care unit and temporary dialysis. In parallel with the demanding care of the patient's physical health, early perinatal palliative intervention was initiated, i.e. accompanying the family after the death of the child. SPIKES communication protocol makes it easier to navigate a difficult conversation in limited time. Commonly established hospital processes may not be prepared for such a complex and demanding situation and require exceptional involvement of the staff from all departments. Sharing our communication skills improves the cooperation with an aggressive patient. Presence of her family is beneficial for communication during difficult times.