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Impact of fetal diagnosis of congenital heart disease on parents

Korean Journal of Pediatrics 2006;49(10):1073-1078.
Published online October 15, 2006.
Impact of fetal diagnosis of congenital heart disease on parents
Eun Young Choi1, Chang Hoon Lee1, Myung Ja Yoon1, Eun Sook Han2, Joon Suk Hong3, Yun Sook Jung2, Jung Yun Choi2
1Department of Pediatrics, College of Medicine, Seoul National University, Seoul
2Department of Pediatrics*, Bundang Seoul National University Hospital, Bundang
3Department of Obstetrics and Gynecology†, Bundang Seoul National University Hospital, Bundang, Kore
선천성 심질환의 산전 진단이 보호자의 임신 유지 결정에 미치는 영향
최은영1, 이창훈1, 윤명자1, 한은숙2, 홍준석3, 정윤숙2, 최정연2
1서울대학교 의과대학 소아과학교실
2분당서울대학교병원 소아과
3분당서울대학교병원 산부인과
Correspondence: 
Jung Yun Choi, Email: choi3628@snu.ac.kr
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¡¾6.0 weeks. The mean age of mothers was 30¡¾3.9 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.
Key Words: Fetal echocardiography , Congenital heart disease , Ethical issues , Illegal abortion


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