Hypoplastic left heart syndrome: Effects of fetal echocardiography on birth prevalence

Antenatal perspective of hypoplastic left heart syndrome: 5 years on

“…Previous studies have reported that the majority of parents faced with this diagnosis opt for termination of pregnancy 4 34 35. In our previous series 43.7% of couples elected to terminate their pregnancies after the diagnosis of HLHS.…”

“…In 1991 Allan mentioned that the introduction of a nationwide protocol for fetal ultrasound scanning would strikingly reduce the numbers of newborn babies with HLHS 34 . In our experience, it has definitely increased the referrals to our specialist fetal echocardiography services but has not reduced the number of newborn babies with the condition as more parents are continuing with their pregnancies.…”

Informed consent and hypoplastic left heart syndrome

“…Other geographic areas with available LST for HLHS have much lower rates of NSS compared to our center [6,11,22,23]. Mothers who chose palliative comfort care for HLHS have been reported more often to work in healthcare and to have more education than mothers who chose surgery, suggesting that they were more knowledgeable about the consequences and serious risks of LST described above [3,7,11,22,23]. This variation in parental choice relates to the way options are presented to parents and reflects different philosophies and approaches among physicians to perinatal ethical decision-making, ranging from traditional "lifesaving" physician values to more open, collaborative discussion about the duration of survival and quality of life after LST for HLHS [18][19][20]25,26].…”

“…Infants with HLHS routinely received palliative comfort care. Advances in prenatal diagnosis, surgical technique, and intensive care have made staged surgical palliation and heart transplantation treatment options for HLHS, with survival rates of up to 70% in specialized centers [3][4][5][6][7]. By contrast, HLHS remains a significant cause of termination of pregnancy and neonatal death [3,6,7].…”

Neonatal Congenital Heart Disease and “Complex” Heart Failure

“…Pulsed‐wave Doppler examination of the atretic aorta may reveal retrograde flow in the aortic arch into the ascending aorta. Importantly, echocardiographic examination allows assessment of the ductus arteriosus as well as the interatrial communication 6 …”