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Background: Requirements of specialized prenatal consultation after prenatal diagnosis of Congenital Heart Disease  (CHD) is increasing, but its impact is not clear. This study was to introduce such a specialized prenatal consultation  service and assess its impact on outcomes of CHD fetuses. Methods: We initiated specialized prenatal consultation in a referral tertiary cardiac center in southern China in  2013. A multidisciplinary team serves as consultants in this service and is especially responsible by two pediatric  cardiologists in regular outpatient clinics. We included CHD fetuses diagnosed from 2011 to 2015 consecutively.  They were divided into before (2011-2013) and after (2014-2015) specialized prenatal consultation groups and their  perinatal outcomes, delivery location and early postnatal survival were compared. Risk factors for termination were  also assessed. Results: Totally, 1032 CHD fetuses were included and 533 accepted specialized prenatal consultation. After initiation  of specialized prenatal consultation, the live birth rate significantly improved (OR=1.59, 95% CI: 1.10-2.29) and  termination rate significantly reduced (OR=0.63, 95% CI: 0.44-0.91) in single CHD fetuses. No significant change  in delivery location and postnatal survival of CHD fetuses were observed after specialized prenatal consultation.  Referrals from district hospitals, along with multiple-lesion CHD, critical CHDs, gestational age<28 weeks at  prenatal diagnosis were risk factors for termination. Conclusion: Specialized prenatal consultation can improve the perinatal outcomes in single CHD fetuses. Education  for district hospitals of standardizing counseling, especially for minor CHD fetuses and timely transferring of mothers  with critical CHDs/multiple CHDs fetus is crucial to improve the outcomes of CHD fetuses further.

clinics in mother and child health

Can we Improve the Perinatal Outcomes and Early Postnatal Survival of Fetuses with Congenital Heart Disease by Initiating Specialized Prenatal Consultation Service