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Associations of Physician Perspectives, Personal Choices, and Counseling for Severe Congenital Heart Defects

Joyce L Woo1, Tara M Swanson2, Shiraz A Maskatia3

  • 1Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Prenatal Diagnosis
|September 23, 2025
PubMed

Insights

Physician counseling for termination of pregnancy or perinatal hospice for congenital heart defects (CHDs) is linked to their personal choices, not just outcome views. Understanding these personal beliefs is key for informed family decisions.

Area of Science:

  • Cardiology
  • Medical Ethics
  • Neonatal Care

Background:

  • Congenital heart defects (CHDs) present complex decisions for families regarding pregnancy termination or perinatal hospice.
  • Physician perspectives on outcomes and personal beliefs may influence prenatal counseling for these challenging situations.

Purpose of the Study:

  • To determine if physician views on congenital heart defect (CHD) outcomes or personal choices influence their counseling on termination of pregnancy (TOP) or perinatal hospice.
  • Investigating the association between physician perspectives and prenatal counseling practices for severe CHDs.

Main Methods:

  • A multicenter survey was conducted among US pediatric cardiologists and congenital heart surgeons from 2016-2018.
  • The survey assessed physician perspectives on CHD outcomes, personal considerations, and counseling for TOP or perinatal hospice.
  • Bivariate analyses were used to examine associations between outcome perspectives, personal choices, and counseling.

Main Results:

  • While 47% believed single-ventricle defects offer good long-term quality of life, most physicians (70%-90%) would consider perinatal hospice for their own child, but few (2%-16%) would choose it over intervention.
  • Physicians considering TOP for themselves were significantly more likely to counsel about TOP (99% vs. 67%).
  • No association was found between institutional practice, outcome perspectives, or personal hospice considerations and counseling practices.

Conclusions:

  • Physician perspectives on single-ventricle outcomes, though guarded, did not correlate with counseling practices.
  • Personal choices and considerations significantly influence counseling regarding termination of pregnancy or perinatal hospice for CHDs.
  • Incorporating physicians' personal beliefs is essential for providing comprehensive counseling to families facing decisions about severe CHDs.
Abstract

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