Department of Pediatrics, Division of Pediatric Cardiology, Lucile Packard Children's Hospital, Stanford University School of Medicine, Palo Alto, CA, USA.
Center for Heart Disease and Mental Health, Heart Institute and Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital and University of Cincinnati College of Medicine, Cincinnati, OU, USA.
Semin Perinatol. 2022 Jun;46(4):151587. doi: 10.1016/j.semperi.2022.151587. Epub 2022 Mar 13.
Prenatal diagnosis of congenital heart disease (CHD) can be a life-altering and traumatic event for expectant parents. Parental anxiety, depression, and traumatic stress are common following a prenatal cardiac diagnosis and if untreated, symptoms often persist long-term. During prenatal counseling, parents must try to manage psychological distress, navigate uncertainty, process complex medical information, and make high-stakes medical decisions for their unborn child and their family. Physicians must deliver the diagnosis, describe the expected perinatal management plan, discuss short and long-term prognoses and introduce elements of uncertainty that may exist for the particular diagnosis. Physican training in these important skills is highly variable and many in our field acknowledge the need for improved guidance on best practices for counseling and supporting parents during pregnancy and early parenthood after prenatal diagnosis, while also sustaining physicians' own emotional well-being. We describe these challenges and the opportunities that exist to improve the current state of prenatal counseling in CHD.
先天性心脏病（CHD）的产前诊断对准父母来说可能是改变人生和造成创伤的事件。在产前心脏诊断后，父母通常会出现焦虑、抑郁和创伤后应激等常见症状，如果得不到治疗，这些症状往往会长期存在。在产前咨询期间，父母必须设法管理心理困扰，应对不确定性，处理复杂的医疗信息，并为未出生的孩子及其家庭做出高风险的医疗决策。医生必须做出诊断，描述预期的围产期管理计划，讨论短期和长期预后，并介绍可能存在于特定诊断的不确定性因素。医生在这些重要技能方面的培训差异很大，我们许多人都认识到，需要改进关于在产前诊断后的妊娠和早期育儿期间为父母提供咨询和支持的最佳实践指南，同时也要维持医生自身的情绪健康。我们描述了这些挑战以及改善 CHD 产前咨询现状的机会。
