Benefits of Prenatal Diagnosis
The benefits of prenatal diagnosis of SVCHD include
an increase in options available to parents, such as seeking
more information through education or testing, terminating
or continuing the pregnancy, choosing their
preferred delivery location, and involving the neonatal
cardiac surgical center.
Prenatal diagnosis of hypoplastic left heart syndrome
(HLHS) is associated with improved clinical status
and survival.8
It allows patients to choose to deliver
close to high-volume surgical centers, which decreases
transport and presurgical mortality.9
In 2001, Mahle
et al10 reported that prenatal diagnosis of HLHS is associated
with improved preoperative management and
fewer perioperative neurological events.This study also
demonstrated that operative mortality and hospital stay
in neonates with HLHS were not affected by prenatal
diagnosis.10 However, in 2013, Landis et al11 reported that
prenatal diagnosis of all CHD did not have an impact on
preoperative or predischarge mortality.
Prenatal diagnosis of CHD has been associated with
greater parental understanding of their child’s condition.12
This increased understanding may be related to
the increased time available for education during multiple
fetal care visits and parents’ receptiveness to education
during the prenatal period, a time when parents are
not focused on their critically ill infant or maternal postpartum
health issues.12
Prenatal diagnosis also allows parents time to move
through 1 or more grief stages during pregnancy and
eases the emotional toll associated with the diagnosis
of SVCHD. A qualitative study involving mothers and
fathers of infants with an antenatal diagnosis of CHD
interviewed during pregnancy and after birth describe
their antenatal decisions as their first parenting decisions.13
These families had time and opportunity to prepare
for the events surrounding the birth, including
choosing a birthing location, organizing child care and
additional maternity/paternity leave, and familiarizing
the mother with where her infant would receive care.13
Thus the parents could recuperate from delivery with an
understanding of what was happening to their infant
and why.1