Fetal anomalies and the pediatrician

The role of the pediatrician begins when the antenatal diagnosis of a congenital anomaly has been confirmed in a high-risk perinatal center. The pediatrician contributes in establishing the prognosis and to discuss the best therapeutic possibilities based upon his own experience and the literature. The pediatrician plays an important role in the informing of the parents, particularly when the malformation is correctable. He will provide them with a complete explanation about the care of the baby, possible complications, and the prognosis. The parents meet the medical staff, see the place where their child will be treated after birth, gain confidence, and prepare the best possible mother-infant and father-infant links. The delivery should be planned in a high-risk perinatal center to avoid the postnatal transportation of a sick newborn infant as well as the separation of the infant from the mother. A planned delivery is essential to permit the pediatrician to prepare and execute an early adapted-to-the-malformation resuscitation and prompt surgery in the hope of reducing mortality and morbidity. After birth, the pediatrician plays a role not only in the pre- and postoperative care, but also in supporting the parents and facilitating their investment in the sick baby. The antenatal diagnosis permits the pediatrician and the surgeon to prepare and optimize the care of the newborn and allows the parents to anticipate the mourning of the imagined infant, providing them time to accept the diagnosis and the sick baby before the birth.