Lack of institutional pathways for referral: results of a survey among pediatric surgeons on prenatal consultation for congenital anomalies

Prenat Diagn. 2013 Sep;33(9):904-7. doi: 10.1002/pd.4165. Epub 2013 Jul 4.

Abstract

Objective: This paper aimed to assess pathways through which pediatric surgeons receive couples for prenatal consultation after prenatal diagnosis.

Method: A questionnaire was mailed to pediatric surgical centers to assess the following: (1) surgical caseload per year; (2) number of centers in which prenatal consultation is offered; (3) presence of a 'structured' prenatal consultation clinic; (4) number of consultations per year; (5) pathways for referral to the pediatric surgeon; and (6) the availability of psychological counseling.

Results: Response rate was 81%, (42/52 centers). Thirty-eight centers (93%) offered prenatal consultation. Seven centers (18%) reported to have a 'structured' clinic in terms of time and location. In 13 centers (34%), 1-9 consultations were carried out, from 10 to 19 in 18 centers (47%), from 20 to over 50 in 7 centers (18%). In 34 centers, internal referrals from the obstetric departments were counseled, and in 28 centers, there were also external referrals. Eleven centers reported that couples were self-referred. Information regarding prenatal counseling was available on the institutional website in 10/38 (26%) centers. Psychological counseling was available in 36 centers.

Conclusion: Despite the fact that the majority of pediatric surgical centers provides prenatal consultation, caseloads are very variable as are referral modalities.

MeSH terms

  • Child
  • Congenital Abnormalities / diagnosis*
  • Congenital Abnormalities / surgery*
  • Continuity of Patient Care / organization & administration
  • Counseling / statistics & numerical data
  • Critical Pathways / organization & administration*
  • Female
  • Humans
  • Pediatrics / organization & administration*
  • Physicians
  • Pregnancy
  • Prenatal Diagnosis*
  • Referral and Consultation / organization & administration*
  • Surgical Procedures, Operative*
  • Surveys and Questionnaires