What Does Palliative Care Mean in Prenatal Diagnosis of Congenital Heart Disease?

Abstract

Palliative care in congenital heart disease is relatively uncommon. A condition in which discussion of palliative care may occasionally arise is in the case of prenatal diagnosis of hypoplastic left heart syndrome. Prenatal diagnosis allows families to be counseled and educated about the anomaly and provides the opportunity for a conscious, deliberate choice between the options of pregnancy termination, interventional management after birth, or nonintervention with palliative care. Multiple factors contribute to the decision making. Despite the improved outcomes, palliative care is still considered a viable option by the congenital heart care provider community. In a large series of consecutive fetuses presenting with hypoplastic left heart syndrome, approximately 11% chose termination of pregnancy and 7% chose postnatal palliative care. As outcomes steadily improve, the threshold for discontinuing the viability of palliative care as an option will be reached.