Maternal Psychological Stress after Prenatal Diagnosis of Congenital Heart Disease

Rychik, Jack; Donaghue, Denise; Levy, Suzanne; Fajardo, C.; Combs, Jill; Zhang, Xuemei; Szwast, Anita; Diamond, Guy

doi:10.1016/j.jpeds.2012.07.023

Cited by 156 publications

(110 citation statements)

References 23 publications

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“…Partner/marital satisfaction was associated with less maternal stress, and use of the coping mechanism of denial was associated with more maternal stress, anxiety, and depression. 423 …”

Section: Maternal and Paternal Effectsmentioning

confidence: 99%

Diagnosis and Treatment of Fetal Cardiac Disease

Donofrio¹,

Moon-Grady²,

Hornberger³

et al. 2014

Circulation

Self Cite

983

543

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Background— The goal of this statement is to review available literature and to put forth a scientific statement on the current practice of fetal cardiac medicine, including the diagnosis and management of fetal cardiovascular disease. Methods and Results— A writing group appointed by the American Heart Association reviewed the available literature pertaining to topics relevant to fetal cardiac medicine, including the diagnosis of congenital heart disease and arrhythmias, assessment of cardiac function and the cardiovascular system, and available treatment options. The American College of Cardiology/American Heart Association classification of recommendations and level of evidence for practice guidelines were applied to the current practice of fetal cardiac medicine. Recommendations relating to the specifics of fetal diagnosis, including the timing of referral for study, indications for referral, and experience suggested for performance and interpretation of studies, are presented. The components of a fetal echocardiogram are described in detail, including descriptions of the assessment of cardiac anatomy, cardiac function, and rhythm. Complementary modalities for fetal cardiac assessment are reviewed, including the use of advanced ultrasound techniques, fetal magnetic resonance imaging, and fetal magnetocardiography and electrocardiography for rhythm assessment. Models for parental counseling and a discussion of parental stress and depression assessments are reviewed. Available fetal therapies, including medical management for arrhythmias or heart failure and closed or open intervention for diseases affecting the cardiovascular system such as twin–twin transfusion syndrome, lung masses, and vascular tumors, are highlighted. Catheter-based intervention strategies to prevent the progression of disease in utero are also discussed. Recommendations for delivery planning strategies for fetuses with congenital heart disease including models based on classification of disease severity and delivery room treatment will be highlighted. Outcome assessment is reviewed to show the benefit of prenatal diagnosis and management as they affect outcome for babies with congenital heart disease. Conclusions— Fetal cardiac medicine has evolved considerably over the past 2 decades, predominantly in response to advances in imaging technology and innovations in therapies. The diagnosis of cardiac disease in the fetus is mostly made with ultrasound; however, new technologies, including 3- and 4-dimensional echocardiography, magnetic resonance imaging, and fetal electrocardiography and magnetocardiography, are available. Medical and interventional treatments for select diseases and strategies for delivery room care enable stabilization of high-risk fetuses and contribute to improved outcomes. This statement highlights what is currently known and recommended on the basis of evidence and experience in the rapidly advancing and highly specialized field of fetal cardiac care.

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“…Partner/marital satisfaction was associated with less maternal stress, and use of the coping mechanism of denial was associated with more maternal stress, anxiety, and depression. 423 …”

Section: Maternal and Paternal Effectsmentioning

confidence: 99%

Diagnosis and Treatment of Fetal Cardiac Disease

Donofrio¹,

Moon-Grady²,

Hornberger³

et al. 2014

Circulation

Self Cite

983

543

View full text Add to dashboard Cite

show abstract

“…Moreover, heavy medical expenses [32] and frequent hospitalizations [33], bring CHD adolescent patients and their family members to other types of complications, from the burden of the disease on the whole family [34], to issues related to the unknown future, treatment program or prognosis. For these reasons, the understanding of CHD parents' needs is crucial to face the diversity and complexity of adolescents with CHD, guiding the whole care delivery.…”

Section: Discussionmentioning

confidence: 99%

The life experience of parents of Congenital Heart Disease adolescents: A meta-synthesis

ore¹

2017

Arch Nursing Pract Care

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Introduction: Congenital Heart Diseases (CHD) do not preclude the possibility to become adult due to the different innovations in medical and surgical treatments. The transition from childhood to adulthood is a complex process in the life of CHD adolescents, considering the consequences of their diseases and the need to be adherent with their follow-up indications. In this process, parents play an important role, being a landmark for their children, but the experiences of CHD adolescents' parents are little studied and the literature about their life experiences appears fragmented. Knowledge of life experience of CHD adolescents' parents is important to address a tailored and effi cient health-care delivery for the whole family. Therefore, the aim of this study is to synthesize qualitative papers of life experience of CHD adolescents' parents. Methods:A meta-synthesis study using Noblit and Hare's interpretative meta-ethnography approach was conducted. Databases searched included PubMed, CINAHL, PsycINFO and Google Schoolar and keywords used are "Congenital heart disease", "Parents", "Adolescents" and "life experience". The search process was performed in accordance with the PRISMA guidelines and only the qualitative papers in the last 20 years were included. Studies resulted by search process were critically appraised using the Critical Appraisal Skills Programme qualitative research appraisal tool. Results:The search yielded 386 potentially relevant studies for screening, and only six articles met all the inclusion criteria. In accordance with the seven phases suggested by Noblit and Hare, the papers were analyzed, discussed and a qualitative meta-synthesis was performed. The meta-synthesis results showed four main themes, exploring also four main contradictions that characterize the life experiences of CHD adolescents' parents: "fear and uncertainty of the future versus positive coping strategies"; "parents hyperresponsibility and overprotection versus adolescents' independence desire"; "desire to give support, but not to be supported"; "normality desire versus awareness to live with particular conditions". Conclusions:The role of the CHD adolescents' parents is diffi cult and they experience some contradictions. This study explore their life experiences in a preliminary way, but further analysis and studies are needed.

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“…24 Fetal cardiology consultations may be extensive and intensified by parental anxiety and grief surrounding the "loss of the idealized child," and the potential for increased prenatal and postnatal morbidity and mortality. In a recent study, 25 40% of mothers who received a prenatal diagnosis of CHD exceeded clinical cutoff values for posttraumatic stress disorder. 25 Higher levels of depression and anxiety were also reported.…”

Section: Family Stressorsmentioning

confidence: 95%

“…In a recent study, 25 40% of mothers who received a prenatal diagnosis of CHD exceeded clinical cutoff values for posttraumatic stress disorder. 25 Higher levels of depression and anxiety were also reported. In a comparison of mothers of hospitalized babies with CHD with prenatal versus postnatal diagnosis, those that received a prenatal diagnosis were more depressed and those that received a postnatal diagnosis were more stressed.…”

Section: Family Stressorsmentioning

confidence: 95%

“…26 Pregnancy is normally a time that most couples report higher partner satisfaction; however, lower partner satisfaction was reported following the diagnosis of CHD. 25 Parents may need counseling during the remainder of the pregnancy to help recover from the loss of the idealized child. 26 Also, additional stress may be experienced if relocation is required for an extended period for delivery and care.…”

Section: Family Stressorsmentioning

confidence: 99%

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Prenatal Counseling and Care for Single-Ventricle Heart Disease: One Center’s Model for Care

Lafranchi

Lincoln

2015

Critical Care Nurse

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Advances in prenatal imaging allow early detection of single-ventricle congenital heart disease, which may enhance prenatal care and maximize care options and decision making. Boston Children's Hospital's Advanced Fetal Care Center and fetal cardiology program provide prenatal counseling and care for single-ventricle congenital heart disease. Key points for optimal prenatal counseling and education include explanation of the diagnosis, delivery, the first surgery, cardiac neurodevelopmental issues, feeding and growth issues, quality of life and long-term care, family stressors, and fetal cardiac intervention. Such counseling and education help families make the difficult decisions required in this situation. (Critical Care Nurse. 2015;35[5]:53-61)

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Maternal Psychological Stress after Prenatal Diagnosis of Congenital Heart Disease

Cited by 156 publications

References 23 publications

Diagnosis and Treatment of Fetal Cardiac Disease

Diagnosis and Treatment of Fetal Cardiac Disease

The life experience of parents of Congenital Heart Disease adolescents: A meta-synthesis

Prenatal Counseling and Care for Single-Ventricle Heart Disease: One Center’s Model for Care

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