Korean J Pediatr.  2006 Oct;49(10):1073-1078. 10.3345/kjp.2006.49.10.1073.

Impact of fetal diagnosis of congenital heart disease on parents

• Choi EY
• Lee CH
• Yoon MJ
• Han ES
• Hong JS
• Jung YS
• Choi JY

• KMID: 2279784
• DOI: http://doi.org/10.3345/kjp.2006.49.10.1073

Abstract

PURPOSE: This study was performed to assess how a fetal diagnosis of congenital heart disease affects parents, as regards pregnancy management and care of infants after birth.
METHODS
Database search to find out abnormal fetal echocardiography performed at Seoul National University Children's Hospital from July 1988 to June 2003 revealed 370 examinations. After excluding both arrhythmias without structural cardiac disease and multiple pregnancies, 299 pregnancies remained and this data formed the basis of this analysis. We retrospectively reviewed the medical records with special attention to pregnancy outcomes and also tried to find out factors influencing parental decisions on whether to continue or terminate pregnancy.
RESULTS
In this study, the mean gestation age at diagnosis was 28+/-6.0 weeks. The mean age of mothers was 30+/-3.9 years old. Younger gestational ages at diagnosis(P=0.000), more severe grades of fetal heart disease(P=0.002) and younger mothers(P=0.014) correlated with terminations of pregnanies. But the grades of fetal status, the grades of associated anomaly, whether in-vitro-fertilization was carried out or not and numbers of previous children were not significant.
CONCLUSION
This study found that the earlier gestational ages at diagnosis, younger maternal age and higher grades of fetal heart disease tended to lead parent to select abortions. Fetal echocardiographies were performed too late. Moreover Koreans have a biased view that malformation is a something incurable and a tragedy not only to oneself, but also to a family. So parents select terminations of pregnancy, even in curable cases. This is very unethical.

Keyword

Fetal echocardiography; Congenital heart disease; Ethical issues; Illegal abortion

MeSH Terms

Abortion, Criminal
Arrhythmias, Cardiac
Bias (Epidemiology)
Child
Diagnosis*
Echocardiography
Ethics
Female
Fetal Heart
Gestational Age
Heart Defects, Congenital*
Heart Diseases
Humans
Infant
Maternal Age
Medical Records
Mothers
Parents*
Parturition
Pregnancy
Pregnancy Outcome
Pregnancy, Multiple
Retrospective Studies
Seoul