Fetal heart disease and interruption of pregnancy: factors influencing the parental decision‐making process

Chenni, Nawal; Lacroze, V.; Pouet, Christophe; Fraisse, Alain; Kreitmann, B.; Gamerre, M.; Boubli, L.; D’ercole, C.

doi:10.1002/pd.2923

Cited by 56 publications

(56 citation statements)

References 14 publications

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“…Initially when determining whether to terminate or continue a pregnancy, parents considered the extent of congenital anomalies and the presence of chromosomal abnormalities (Chenni et al, 2012; Menahem and Grimwade, 2003; Rauch et al, 2005; Zyblewski et al, 2009). The severity of the heart defect (Chenni et al, 2012) and the presence of a chromosomal abnormality were associated with proceeding or terminating the pregnancy when a heart defect was identified (Rauch et al, 2005). One study found that the presence of multiple anomalies rather than a single anomaly led parents to terminate a pregnancy because of the more anomalies the increased chance for additional infant morbidity (Rauch et al, 2005).…”

Section: Resultsmentioning

confidence: 99%

“…Mothers of premature infants who had secondary education levels were more likely than mothers with primary education to attempt save an infant at ‘all costs’ (Lam et al, 2009). Several other variables were explored in four studies (Chenni et al, 2012; Lam et al, 2009; Rauch et al, 2005; Zyblewski et al, 2009) with mixed results on whether certain demographic characteristics influenced decision-making. Factors that remained inconclusive were maternal age, maternal gravida, maternal parity, race/ethnicity, and gender of the fetus (Chenni et al, 2012; Lam et al, 2009; Rauch et al, 2005; Zyblewski et al, 2009).…”

Section: Resultsmentioning

confidence: 99%

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Parental decision-making for medically complex infants and children: An integrated literature review

Allen

2014

International Journal of Nursing Studies

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Background Many children with life-threatening conditions who would have died at birth are now surviving months to years longer than previously expected. Understanding how parents make decisions is necessary to prevent parental regret about decision-making, which can lead to psychological distress, decreased physical health, and decreased quality of life for the parents. Objective The aim of this integrated literature review was to describe possible factors that affect parental decision-making for medically complex children. The critical decisions included continuation or termination of a high-risk pregnancy, initiation of life-sustaining treatments such as resuscitation, complex cardiothoracic surgery, use of experimental treatments, end-of-life care, and limitation of care or withdrawal of support. Design PubMed, Cumulative Index of Nursing and Allied Health Literature, and PsycINFO were searched using the combined key terms ‘parents and decision-making’ to obtain English language publications from 2000 to June 2013. Results The findings from each of the 31 articles retained were recorded. The strengths of the empirical research reviewed are that decisions about initiating life support and withdrawing life support have received significant attention. Researchers have explored how many different factors impact decision-making and have used multiple different research designs and data collection methods to explore the decision-making process. These initial studies lay the foundation for future research and have provided insight into parental decision-making during times of crisis. Conclusions Studies must begin to include both parents and providers so that researchers can evaluate how decisions are made for individual children with complex chronic conditions to understand the dynamics between parents and parent–provider relationships. The majority of studies focused on one homogenous diagnostic group of premature infants and children with complex congenital heart disease. Thus comparisons across other child illness categories cannot be made. Most studies also used cross-sectional and/or retrospective research designs, which led to researchers and clinicians having limited understanding of how factors change over time for parents.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Parental decision-making for medically complex infants and children: An integrated literature review

Allen

2014

International Journal of Nursing Studies

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“…Several other pregnancy variables are known to influence the decision to terminate pregnancy, such as maternal age, gravida, parity, gestational age at time of diagnosis, religion and socioeconomic status [16,17,21]. Furthermore, survival rate can be influenced by many other factors [22][23][24], such as term of birth or birth weight.…”

Section: Study Limitationsmentioning

confidence: 97%

“…In the majority of studies, CHDs associated with extracardiac anomalies have worse outcomes [10][11][12][13][14][15]. However, relatively few studies have evaluated the overall effect of known genetic syndromes and major ECMs on pregnancy outcome and mortality in fetal CHD [16,17].…”

Section: Introductionmentioning

confidence: 99%

Associated genetic syndromes and extracardiac malformations strongly influence outcomes of fetuses with congenital heart diseases

Bensemlali

Bajolle

Ladouceur

et al. 2016

Archives of Cardiovascular Diseases

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“…(26) However, study of fetuses with heart disease found that gestational age upon diagnosis was a major factor for the parents to make decision for termination of pregnancy (<0.001). (27) …”

Section: Discussionmentioning

confidence: 99%

Association of gestational age with the option of pregnancy termination for fetal abnormalities incompatible with neonatal survival

Westphal

Fustinoni

Pinto

et al. 2016

Einstein (São Paulo)

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Objective:To identify the profile of women seen in a Fetal Medicine unit, diagnosed with fetal abnormality incompatible with neonatal survival in their current pregnancy, and to check the association of gestational age upon diagnosis with the option of pregnancy termination.Methods:This is a retrospective cohort study carried out in the Fetal Medicine Outpatients Clinic of a university hospital, in the city of São Paulo (SP), Brazil, using medical records of pregnant women with fetus presenting abnormalities incompatible with neonatal survival. The sample comprised 94 medical records. The Statistical Package for the Social Sciences (SPSS), version 19, was used for the data statistical analysis.Results:The population of the study included young adult women, who had complete or incomplete high school education, employed, with family income of one to three minimum wages, single, nonsmokers, who did not drink alcoholic beverages or used illicit drugs. Women with more advanced gestational age upon fetal diagnosis (p=0.0066) and/or upon admission to the specialized unit (p=0.0018) presented a lower percentage of termination of pregnancy.Conclusion:Due to characteristics different from those classically considered as of high gestational risk, these women might not be easily identified during the classification of gestational risk, what may contribute to a late diagnosis of fetal diseases. Early diagnosis enables access to specialized multiprofessional care in the proper time for couple's counseling on the possibility of requesting legal authorization for pregnancy termination.

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Fetal heart disease and interruption of pregnancy: factors influencing the parental decision‐making process

Cited by 56 publications

References 14 publications

Parental decision-making for medically complex infants and children: An integrated literature review

Parental decision-making for medically complex infants and children: An integrated literature review

Associated genetic syndromes and extracardiac malformations strongly influence outcomes of fetuses with congenital heart diseases

Association of gestational age with the option of pregnancy termination for fetal abnormalities incompatible with neonatal survival

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