Fetal and post-natal diagnosis of major XXXX : implications for medical and psychological care in the current era.

@entity1 @entity75 @entity3886 @entity1757 @entity299 @entity1146
AIM: The fetal or post-natal diagnosis of major @entity299 has important medical and psychological consequences. METHODS: We reviewed @entity1 who underwent cardiac surgery in the first year of life at the Heart Centre for @entity1 , The @entity1 's Hospital at Westmead during 2009. The aims of this study were to: (i) examine the key features of cardiac diagnosis and clinical outcome, and (ii) consider how these data can inform priorities for the delivery of clinical services. RESULTS: Over the 12-month study period, a first cardiac surgical procedure was performed on 195 @entity1 , with 85 @entity1 (44%) diagnosed in the antenatal period. Of the total sample, a subset of 90 babies (46%) underwent their first procedure in the neonatal period, with 62% having had a fetal diagnosis. Major @entity75 including truncus arteriosus (100%), single ventricular lesions (83%), @entity1146 with @entity1757 (78%) and @entity3886 (53%) were diagnosed prior to birth. Improved haemodynamic stability at initial presentation was found in those with a fetal diagnosis. The overall mortality rate for all @entity1 was 6.1% at 12 months, with a higher mortality in @entity1 with single ventricle. CONCLUSIONS: The contemporary paradigm of care for @entity1 with major @entity299 requires a multidisciplinary approach to care, with improvements in clinician-clinician and clinician-family communication, and psychological support and education for families. Changes in the allocation of resources are required to meet this model of best practice.
