Prenat Diagn. 2025 Sep 23. doi: 10.1002/pd.6901. Online ahead of print.
ABSTRACT
OBJECTIVE: To assess whether physicians’ perspectives of outcomes or personal choices are associated with prenatal counseling for termination of pregnancy (TOP) or perinatal hospice for severe congenital heart defects (CHDs).
METHOD: Multicenter survey of pediatric cardiologists and congenital heart surgeons in the United States, 2016-2018. The survey measured perspectives of CHD outcomes, personal choices/considerations, and prenatal counseling for TOP or perinatal hospice. Bivariate comparisons estimated associations between outcome perspectives, personal choices, and counseling.
RESULTS: Response rate was 77% (135/176); 47% (63/135) believed that single-ventricle portends good long-term quality of life or transplant-free survival. The majority (70%-90% depending on CHD type) would consider perinatal hospice for their own child, but a minority (2%-16% depending on CHD type) would choose perinatal hospice over TOP or postnatal intervention. Physicians who would consider TOP for themselves/their partner were more likely to counsel about TOP than physicians who would not consider TOP for themselves/their partner (99% vs. 67%, p < 0.001). There were no associations between institutional practice, outcome perspectives, personal consideration for hospice, and counseling practices.
CONCLUSION: Physician perspectives of single-ventricle outcomes remain guarded but were not associated with counseling. However, personal choices/considerations are associated with counseling practices; therefore, considering personal beliefs is crucial to help families make fully informed decisions.
PMID:40988087 | DOI:10.1002/pd.6901
