Sunday, Sep 26 - Expo Hall Opening
Sunday, Sep 26 - Job Fair
Monday,
Sep 27 - AWHONN's Block Party
Sunday, September 26, 2010
Title: No Barriers Exist: Providing Care for the Fetus with Complex Cardiac Anomalies in the Most Appropriate Setting
Discipline: Professional Issues (PI), Childbearing (CB)
Learning Objectives:
Submission Description:- The learner will be able to state fetal structural cardiac anomalies that may require immediate surgical intervention.
- The learner will be able to summarize the key elements required to coordinate one surgical team from two medical centers.
- The learner will be able to identify legal barriers that exist when providing services outside one's health care institution.
No Barriers Exists: Providing Care for the Fetus with Complex Cardiac Anomalies in the Most Appropriate Setting
AORN has reported that the perioperative setting is one of the most potentially hazardous of all clinical settings. Knowing that, these hazards can ultimately affect patient outcomes. When addressing the obstetrical patient in the operative setting the obstetrical team must remember that there is not only one patient but two distinct patients. Typically, a c-section delivery in our level III unit that involves a healthy mother with a fetus with known anomalies can be successfully performed without affecting neonatal outcomes. Even most fetal structural cardiac anomalies that are estimated to occur in 8 of 1,000 births can be stabilized in our level III unit prior to transfer to a pediatric hospital specializing in cardiac surgery. Our hospital has had the honor and experience of delivering neonates with known structural cardiac anomalies who arrive to our hospital from Europe as well as across the United States for follow up cardiac surgery at our local pediatric hospital. However, some neonates with structural cardiac anomalies, such as hypoplastic left heart syndrome (HLHS) and a narrowed ductus arteriosus, will develop life-threatening shock prior to transfer to a pediatric cardiac center. Our level III obstetrical unit was faced with a challenge and responded to the special needs of a neonate with HLHS and a narrowed ductus arteriosus. Using a multidisciplinary approach, a team from obstetrics, perinatology, neonatal cardiac surgery, as well as the patient, a decision was made to deliver the neonate in the most appropriate setting. The most appropriate setting was a planned c-section delivery outside of a level III obstetrics unit at a pediatric cardiac center. Combining the knowledge and expertise of the obstetrical team and the pediatric cardiac team, the first coordinated and successful c-section delivery occurred at a local and renown pediatric cardiac center. The presentation will also include legal issues that are of little concern to either health care provider team but a valid barrier when providing health care outside of one’s’ health care institution.
AORN has reported that the perioperative setting is one of the most potentially hazardous of all clinical settings. Knowing that, these hazards can ultimately affect patient outcomes. When addressing the obstetrical patient in the operative setting the obstetrical team must remember that there is not only one patient but two distinct patients. Typically, a c-section delivery in our level III unit that involves a healthy mother with a fetus with known anomalies can be successfully performed without affecting neonatal outcomes. Even most fetal structural cardiac anomalies that are estimated to occur in 8 of 1,000 births can be stabilized in our level III unit prior to transfer to a pediatric hospital specializing in cardiac surgery. Our hospital has had the honor and experience of delivering neonates with known structural cardiac anomalies who arrive to our hospital from Europe as well as across the United States for follow up cardiac surgery at our local pediatric hospital. However, some neonates with structural cardiac anomalies, such as hypoplastic left heart syndrome (HLHS) and a narrowed ductus arteriosus, will develop life-threatening shock prior to transfer to a pediatric cardiac center. Our level III obstetrical unit was faced with a challenge and responded to the special needs of a neonate with HLHS and a narrowed ductus arteriosus. Using a multidisciplinary approach, a team from obstetrics, perinatology, neonatal cardiac surgery, as well as the patient, a decision was made to deliver the neonate in the most appropriate setting. The most appropriate setting was a planned c-section delivery outside of a level III obstetrics unit at a pediatric cardiac center. Combining the knowledge and expertise of the obstetrical team and the pediatric cardiac team, the first coordinated and successful c-section delivery occurred at a local and renown pediatric cardiac center. The presentation will also include legal issues that are of little concern to either health care provider team but a valid barrier when providing health care outside of one’s’ health care institution.
