Association between parental decisions regarding abortion and severity of fetal heart disease.

The prenatal diagnosis of fetal heart disease potentially influences parental decision-making regarding pregnancy termination. Existing literature indicates that the severity, whether in complexity or lethality, significantly influences parental decisions concerning abortion. However, questions remain as to how fetal heart disease severity impacts parental decisions, given recent advancements in postsurgical outcomes. Therefore, we investigated risk factors associated with parents' decision-making regarding abortion following a prenatal diagnosis of fetal heart disease. Our analysis included 73 (terminated: n = 37; continued: n = 36) pregnancies with a fetal heart disease diagnosed before 22 weeks of gestation. Increased gestational age at diagnosis reduced the likelihood of parents' decision on termination (Model 1: adjusted odds ratio, 0.94; 95% confidence interval 0.89-0.99; Model 2: 0.95 0.90-0.997). Critical disease (5.25; 1.09-25.19) and concurrent extracardiac or genetic abnormalities (Model 1: 4.19, 1.21-14.53; Model 2: 5.47, 1.50-19.96) increased the likelihood of choosing abortion. Notably, complex disease did not significantly influence parental decisions (0.56; 0.14-2.20). These results suggest that parental decision-making regarding abortion may be influenced by earlier gestational age at diagnosis, the lethality of heart disease, and extracardiac or genetic abnormalities, but not its complexity if prenatal diagnosis and parental counseling are provided at a cardiovascular-specialized facility.

Intrapartum fetal heart rate pattern in oligohydramnios.

OBJECTIVES: It was the aim of this study to examine intrapartum fetal heart rate (FHR) patterns in oligohydramnios. METHODS: Subjects comprised 24 singleton pregnant women diagnosed with oligohydramnios and 470 controls. FHR patterns were analyzed at the end of the first stage and throughout the whole second stage of labor. Numbers of variable deceleration (VD), early deceleration (ED), late deceleration (LD) and prolonged deceleration (PD) per contraction were counted. RESULTS: Frequencies of decelerations in oligohydramnios and controls were 5.4 +/- 14.5 and 2.0 +/- 6.6% for ED, 0.0 and 0.4 +/- 2.5% for LD, 17.6 +/- 20.6 and 12.2 +/- 13.3% for VD, and 1.8 +/- 3.7 and 0.8 +/- 3.0% for PD in the first stage of labor. In the second stage, frequencies were as follows: 5.1 +/- 10.5 and 1.5 +/- 6.1% for ED, 0.5 +/- 1.7 and 1.0 +/- 4.4% for LD, 30.1 +/- 22.0 and 43.9 +/- 29.3% for VD, and 29.3 +/- 33.2 and 12.6 +/- 22.5% for PD. CONCLUSIONS: In cases of oligohydramnios, ED occurred frequently from the first stage of labor. In the second stage of labor, the frequency of PD was extremely high and the frequency of VD was low.