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Infants with prenatally diagnosed anomalies: special approaches to preparation and resuscitation
Christopher E Colby1, William A Carey, Yair J Blumenfeld
1Department of Pediatrics, Neonatal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. colby.christopher@mayo.edu
Insights
A multidisciplinary approach is crucial for managing suspected fetal anomalies. This framework integrates prenatal diagnosis, maternal-fetal care, delivery planning, and neonatal care for complex infant conditions.
Area of Science:
- Perinatal medicine
- Fetal surgery
- Neonatology
Background:
- Suspected fetal anomalies necessitate a coordinated management strategy.
- Current approaches often lack integration across prenatal and neonatal care stages.
- Comprehensive planning is vital for optimizing outcomes in infants with complex congenital conditions.
Purpose of the Study:
- To provide a framework for integrating prenatal diagnosis and maternal-fetal care with delivery and neonatal management.
- To outline considerations for infants with complex anomalies, including congenital heart disease and neural tube defects.
- To facilitate the development of thoughtful management plans for affected infants.
Main Methods:
- Review of existing literature and clinical guidelines.
- Development of a multidisciplinary care model.
- Integration of diagnostic, therapeutic, and postnatal care elements.
Main Results:
- A structured approach encompassing diagnosis, counseling, pregnancy management, surveillance, delivery planning, and neonatal care.
- Specific considerations for diverse anomalies such as congenital heart disease, intrathoracic masses, and abdominal wall defects.
- Emphasis on special resuscitation needs and immediate/later neonatal evaluation.
Conclusions:
- A multidisciplinary, integrated framework is essential for managing complex fetal anomalies.
- Early and comprehensive planning improves outcomes for infants with prenatally diagnosed conditions.
- This approach supports informed decision-making for families and healthcare providers.
Abstract:
When a fetal anomaly is suspected, a multidisciplinary approach to diagnosis, counseling, pregnancy management, surveillance, delivery planning, and neonatal care is critical to creating a comprehensive management plan. This article provides a basic framework for integrating prenatal diagnostic and maternal-fetal care considerations, delivery planning, special resuscitation needs, and immediate and later neonatal care and evaluation into developing a thoughtful management plan for infants with prenatally diagnosed complex anomalies including congenital heart disease, intrathoracic masses, fetal airway obstruction, neural tube defects, abdominal wall defects, and skeletal dysplasia.
