Trisomy 18 and complex congenital heart disease: seeking the threshold benefit

Pediatrics. 2013 Jul;132(1):161-5. doi: 10.1542/peds.2012-3643. Epub 2013 Jun 3.

Abstract

A prenatal diagnosis of ductal-dependent, complex congenital heart disease was made in a fetus with trisomy 18. The parents requested that the genetic diagnosis be excluded from all medical and surgical decision-making and that all life-prolonging therapies be made available to their infant. There was conflict among the medical team about what threshold of neonatal benefit could outweigh maternal and neonatal treatment burdens. A prenatal ethics consultation was requested.

Keywords: cardiac surgery; decision-making; ethics; trisomy 18.

Publication types

  • Case Reports

MeSH terms

  • Abortion, Eugenic
  • Animals
  • Cesarean Section / ethics
  • Chromosomes, Human, Pair 18 / genetics*
  • Cooperative Behavior
  • Cost of Illness
  • Double Outlet Right Ventricle / diagnosis*
  • Double Outlet Right Ventricle / genetics*
  • Double Outlet Right Ventricle / therapy*
  • Echocardiography
  • Ethics Consultation
  • Ethics, Medical*
  • Female
  • Fetal Death
  • Fetal Growth Retardation / diagnosis
  • Heart Ventricles / abnormalities*
  • Humans
  • Infant, Newborn
  • Interdisciplinary Communication
  • Life Support Care / ethics
  • Parental Consent / ethics
  • Pregnancy
  • Prenatal Diagnosis / ethics*
  • Religion and Medicine
  • Risk Assessment
  • Treatment Refusal
  • Trisomy*
  • Ultrasonography, Prenatal