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Prenatal Counseling and Care for Single-Ventricle Heart Disease: One Center's Model for Care
Terra Lafranchi1, Patricia Lincoln2
1Terra Lafranchi is a nurse practitioner in the Department of Cardiology at Boston Children's Hospital. She is the fetal cardiology coordinator and also provides longitudinal pediatric cardiac care.Patricia Lincoln is a clinical nurse specialist in the cardiovascular intensive care unit at Boston Children's Hospital. terra.lafranchi@cardio.chboston.org.
Insights
Prenatal imaging advances enable early detection of single-ventricle congenital heart disease. Comprehensive counseling aids families in making informed decisions regarding treatment and care options.
Area of Science:
- Pediatric Cardiology
- Fetal Medicine
- Congenital Heart Disease
Background:
- Single-ventricle congenital heart disease (SVCHD) is a complex condition requiring specialized care.
- Advances in prenatal imaging facilitate earlier diagnosis of fetal cardiac anomalies.
- Prenatal diagnosis of SVCHD impacts management strategies and family planning.
Purpose of the Study:
- To outline key components of optimal prenatal counseling for SVCHD.
- To emphasize the role of specialized fetal care centers in managing SVCHD.
- To support families in navigating complex decisions related to SVCHD.
Main Methods:
- Review of current practices in prenatal diagnosis and counseling for SVCHD.
- Identification of essential information for families facing SVCHD diagnosis.
- Integration of multidisciplinary expertise in fetal cardiology and cardiac surgery.
Main Results:
- Early detection via prenatal imaging is crucial for timely intervention.
- Comprehensive counseling addresses diagnosis, delivery, surgical plans, neurodevelopment, and long-term outcomes.
- Multidisciplinary care enhances support for families and optimizes infant outcomes.
Conclusions:
- Optimal prenatal counseling empowers families with knowledge for decision-making.
- Specialized fetal care programs are vital for managing SVCHD.
- Improved prenatal care and education lead to better quality of life for affected children.
Abstract:
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.
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