Evidence-Based Fetal Referrals for Congenital Heart Surgery

Abstract

Background. The outcomes of fetal referrals to congenital heart disease centers for delivery and postnatal surgery prior to discharge over a two-year period were reviewed. Cost differences between fetal referrals and neonatal transports were investigated. Methods. A retrospective chart review was conducted on 17 fetal referrals to two congenital heart disease centers from 01/01/2007 to 12/31/2008. The two centers were contacted to obtain their neonatal transport charges. Results. Of the 17 fetal referrals, 10 patients underwent congenital heart surgery prior to postnatal discharge. Only one patient who underwent surgery died. Third party payers saved approximately $13,600 or $36,600 in neonatal transport costs to these centers. Conclusions. There was only one death of a patient with hypoplastic left heart syndrome and a restrictive atrial septum, which has a poor prognosis. There was a significant cost differential between fetal referral and neonatal transport.