Outcomes of management decisions by parents for their infants with hypoplastic left heart syndrome born with and without a prenatal diagnosis

Journal of Paediatrics and Child Health
James Tibballs, Annie Cantwell-Bartl

Abstract

To study the influence of a prenatal diagnosis on parental choice of treatment for infants born with hypoplastic left heart syndrome (HLHS). Retrospective review of medical records of infants admitted to a paediatric tertiary hospital 1983-2004 with a diagnosis of HLHS. A total of 201 infants had HLHS diagnosed by echocardiography after birth with 129 subsequently undergoing surgery and 72 non-surgical management (compassionate/comfort care). When the diagnosis of HLHS was made prenatally, 68 of 71 (96%) infants underwent surgery whereas when the diagnosis was made post-natally 61 of 130 (47%) infants underwent surgery. Prenatal diagnosis was significantly associated with a parental choice of surgery (P < 0.001). Among 72 infants managed non-surgically, compassionate care was chosen by parents for 49 (68%) despite being fit for surgery, 20 (28%) were deemed unfit for surgery and in three (4%) the reasons for non-surgical management were unknown. Of the total 178 infants considered fit for surgery, 68 (38%) had had a prenatal diagnosis and 110 (62%) did not. Of 20 considered unfit for surgery, none had had a prenatal diagnosis. A prenatal diagnosis was significantly associated with fitness for surgery (P < 0.001). Approximately ...Continue Reading

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Citations

Dec 14, 2011·Cardiology in the Young·Constantine MavroudisEric D Kodish
Mar 31, 2012·ISRN Obstetrics and Gynecology·Shigetaka MatsunagaHiroo Maeda
Nov 23, 2011·Expert Review of Cardiovascular Therapy·Abdullah A AlghamdiGlen S Van Arsdell
Dec 19, 2012·Journal of Pediatric Nursing·Sarah ToebbeJennifer Coddington
Jun 30, 2009·The Journal of Pediatrics·Lainie Friedman Ross, Joel Frader
Sep 4, 2013·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·Lami Yeo, Roberto Romero
Jul 31, 2013·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Hanna K MarkkanenTiina H Ojala
Jul 25, 2009·Journal of Perinatology : Official Journal of the California Perinatal Association·A MalhotraL Gillam
Aug 24, 2013·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Annie M Cantwell-Bartl, James Tibballs
Aug 20, 2018·Pediatric Cardiology·Roland W WeberEmanuela R Valsangiacomo Buechel
Apr 1, 2018·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Lami YeoRoberto Romero
Oct 23, 2020·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Ran ChenBowen Zhao

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