Assessment of Needs for Counseling After Prenatal Diagnosis of Congenital Heart Disease – A Multidisciplinary Approach

Kovacevic, Alexander; Simmelbauer, Andreas; Starystach, Sebastian; Elsässer, Michael; Sohn, Christof; Müller, Andreas; Bär, Stefan; Gorenflo, Matthias

doi:10.1055/a-0633-3331

Cited by 12 publications

(15 citation statements)

References 19 publications

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“…A multidisciplinary cooperation between sociologists, cardiologists, and MFM specialists resulted in the development and consecutive validation of a questionnaire (10). We believe that this interdisciplinary approach significantly adds to the strength of this study.…”

Section: Discussionmentioning

confidence: 88%

Counseling for Prenatal Congenital Heart Disease—Recommendations Based on Empirical Assessment of Counseling Success

et al. 2020

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Objectives: Empirical assessment of parental needs and affecting factors for counseling success after prenatal diagnosis of congenital heart disease (CHD). Methods: Counseling success after fetal diagnosis of CHD was assessed by a validated standardized questionnaire. The dependent variable "Effective Counseling" was measured in five created analytical dimensions (1. "Transfer of Medical Knowledge-ToMK"; 2. "Trust in Medical Staff-TiMS"; 3. "Transparency Regarding the Treatment Process-TrtTP"; 4. "Coping Resources-CR"; 5. "Perceived Situational Control-PSC"). Analyses were conducted with regard to influencing factors and correlations.

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Section: Discussionmentioning

confidence: 88%

Counseling for Prenatal Congenital Heart Disease—Recommendations Based on Empirical Assessment of Counseling Success

et al. 2020

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“…However, to be able to correctly assess the prognosis of fetuses with CHDs and to accurately identify those who require immediate intervention, a multidisciplinary team involving pediatric cardiologists, obstetricians, pediatric cardiac surgeons and other pediatric specialists is necessary. The quality and completeness of the information on what should be expected of the child would likely influence the decisions the parents make: in some cases, whether to sustain the pregnancy or not 711. In this paper, the purpose was to assess the effect of multidisciplinary approach on delivery of infants with prenatally diagnosed CHDs by comparing the likelihood of giving birth to a child according to the specialists who participated in the initial assessment and according to the initial diagnosis made by the echocardiography examination.…”

Section: Discussionmentioning

confidence: 99%

“…Proper planning requires interaction between diverse specialists; pediatric cardiologists to perform echocardiography to examine the structure and hemodynamics of the fetal heart, pediatric cardiac surgeons to devise necessary surgical corrections, and obstetricians for planning of the delivery. Multidisciplinary approach would not only allow improvement in the area of perinatal management but it is also expected that such approach would give opportunities to develop prenatal techniques; that is, techniques to manage CHD patients within the uterus, or prior to birth 7. For this reason there had been notions around the globe on the importance of assembling multidisciplinary teams for the care of fetuses with CHDs.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Multidisciplinary Approach on the Birth Rate of Fetuses with Prenatally Diagnosed Congenital Heart Disease

et al. 2019

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Background This study aimed to determine the effect of a multidisciplinary approach on the birth rate of fetuses with prenatally diagnosed congenital heart diseases (CHDs). Methods Among the fetuses of 724 gravidas who underwent fetal echocardiography in Samsung Medical Center from January 2013 to June 2017, 463 fetuses with normal cardiac structure, arrhythmia or simple left-to-right shunt were excluded, and the remaining 261 were included in the study. The subjects were subdivided into groups based on whether they were consulted multidisciplinarily, that is, consulted simultaneously by pediatric cardiologists, obstetricians and pediatric cardiac surgeons or not. They were also categorized based on the initial fetal echocardiogram results. Results Among the fetuses in the multidisciplinary group, 64.5% of the fetuses were given birth to, and the proportion was not different from that in the non-multidisciplinary group (68.6%, P = 0.48). The delivery rate in the multidisciplinary consultation group were 69.2% in the transposition of the great arteries group, 63.6% in the tetralogy of Fallot group, 68.8% in the pulmonary atresia or interrupted aortic arch group, 62.5% in the coarctation of aorta group, 60.0% in the atrioventricular septal defect group, 70.0% in the functional single ventricle group, and 55.6% in the hypoplastic left heart syndrome group; there were no significant differences between the 10 echocardiogram groups. However, when the subjects were categorized into Fontan repair group and biventricular repair group, the Fontan repair group showed a significant increase in the likelihood of delivery when a multidisciplinary approach was taken ( P = 0.035). Conclusion When a fetus was diagnosed with a CHD where Fontan repair should be considered, a multidisciplinary approach resulted in increased possibility of delivery.

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“…To assess parental counselling comprehensively, we used a pretested and validated questionnaire, developed after interdisciplinary collaboration between cardiologists, MFM specialists, and sociologists [10].…”

Section: Methodsmentioning

confidence: 99%

“…An objective assessment of "Counselling success" (= dependent variable) was performed by creating five analytical dimensions as described by our group earlier [10]. Pretesting showed sufficient internal consistency; further methodical aspects are published elsewhere [10].…”

Section: Methodsmentioning

confidence: 99%

Objective Assessment of Counselling for Fetal Heart Defects: An Interdisciplinary Multicenter Study

Kovacevic

Bär

Starystach

et al. 2020

JCM

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The objective of this study was to analyze parental counselling for fetal heart disease in an interdisciplinary and multicenter setting using a validated questionnaire covering medical, sociodemographic, and psychological aspects. n = 168 individuals were recruited from two pediatric heart centers and two obstetrics units. Overall, counselling was combined successful and satisfying in >99%; only 0.7% of parents were dissatisfied. "Perceived situational control" was impaired in 22.6%. Adequate duration of counselling leads to more overall counselling success (r = 0.368 ***), as well as providing written or online information (57.7% vs. 41.5%), which is also correlated to more "Transfer of Medical Knowledge" (r = 0.261 ***). Interruptions of consultation are negatively correlated to overall counselling success (r = −0.247 **) and to "Transparency regarding the Treatment Process" (r = −0.227 **). Lacking a separate counselling room is associated with lower counselling success for "Transfer of Medical Knowledge" (r = 0.210 ***). High-risk congenital heart disease (CHD) is correlated to lower counselling success (42.7% vs. 71.4% in low-risk CHD). A lack of parental language skills leads to less overall counselling success. There is a trend towards more counselling success for "Transfer of Medical Knowledge" after being counselled solely by cardiologists in one center (r = 0.208). Our results indicate that a structured approach may lead to more counselling success in selected dimensions. For complex cardiac malformations, counselling by cardiologists is essential. Parental "Perceived Situational Control" is often impaired, highlighting the need for further support throughout the pregnancy.

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Assessment of Needs for Counseling After Prenatal Diagnosis of Congenital Heart Disease – A Multidisciplinary Approach

Cited by 12 publications

References 19 publications

Counseling for Prenatal Congenital Heart Disease—Recommendations Based on Empirical Assessment of Counseling Success

Counseling for Prenatal Congenital Heart Disease—Recommendations Based on Empirical Assessment of Counseling Success

The Effect of Multidisciplinary Approach on the Birth Rate of Fetuses with Prenatally Diagnosed Congenital Heart Disease

Objective Assessment of Counselling for Fetal Heart Defects: An Interdisciplinary Multicenter Study

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