Neonatal and maternal outcomes of pregnancies with a fetal diagnosis of congenital heart disease using a standardized delivery room management protocol

J Perinatol. 2020 Feb;40(2):316-323. doi: 10.1038/s41372-019-0528-1. Epub 2019 Oct 14.

Abstract

Objective: We sought to determine if fetuses with prenatally diagnosed congenital heart disease (CHD) were more likely to undergo cesarean delivery in the setting of a non-reassuring fetal heart rate tracing (NRFHT) and to determine if those fetuses were more likely to have a fetal acidosis.

Study design: A retrospective cohort study of neonates prenatally diagnosed with CHD from August 2010 to July 2016. The control group consisted of gestational age matched controls without CHD.

Results: Each group consisted of 143 patients. The most common reason for cesarean delivery was a NRFHT (control 31% vs CHD 35%, p = 0.67). Fetal acidosis was a rare outcome occurring in only five controls (3.5%) and 11 cases (7.7%) (p = 0.12).

Conclusion: These findings demonstrate that with multidisciplinary care coordination, fetuses with a prenatal diagnosis of CHD have similar cesarean rates, labor and delivery management, and delivery room compromise as healthy fetuses.

MeSH terms

  • Cesarean Section / statistics & numerical data*
  • Delivery Rooms
  • Delivery, Obstetric / standards*
  • District of Columbia
  • Female
  • Fetal Diseases / diagnosis
  • Gestational Age
  • Heart Defects, Congenital* / diagnosis
  • Heart Defects, Congenital* / therapy
  • Heart Rate, Fetal
  • Hospitals, Pediatric
  • Humans
  • Infant, Newborn
  • Male
  • Patient Care Management / methods
  • Patient Care Management / standards*
  • Pregnancy
  • Pregnancy Outcome
  • Prenatal Diagnosis*
  • Retrospective Studies