What question did this study set out to answer?

To assess the effectiveness of a risk-stratified postnatal management pathway for newborns with prenatal concerns of coarctation of the aorta.

May 10, 2026Journal of Perinatology0 citationsOpen Access

Implementation of a coarctation personalized longitudinal algorithm for newborns (Coarc-PLAN) in the care of patients with prenatal concern for coarctation of the aorta

MCMeghan A CoghlanNorthwestern University CFCatherine FittLurie Children's Hospital KHKelli HatterNorthwestern University

Key Points

To assess the effectiveness of a risk-stratified postnatal management pathway for newborns with prenatal concerns of coarctation of the aorta.
Retrospective cohort study of fetuses with concern for coarctation of the aorta on fetal echocardiogram.
Postnatal care recommendations were tiered based on prenatal risk categories: mild, moderate, and high concern.
Outcomes measured included the rate of coarctation repair and necessity of ICU transfer.
For the mild concern category, 3% (1 of 40) underwent CoA repair before discharge.
Among moderate concern newborns, 38% (5 of 13) required surgery prior to discharge and 6 transferred to CICU.
82% (28 of 34) in the high concern category had CoA repair prior to discharge.

Abstract

Abstract Objective To evaluate the ability of a tiered, risk-stratified postnatal management pathway to safely provide monitoring and postnatal care recommendations based on the prenatal Coarctation of Aorta (CoA) risk category. Methods Retrospective cohort study of fetuses with CoA concern on fetal echocardiogram. Postnatal recommendations were based on prenatal risk categories as follows: mild-concern (nursery, echo before discharge); moderate-concern (NICU, echo before 24 h); high-concern (PGE infusion, CICU, admission echo). Results For mild (40/87), moderate (13/87), and high (34/87) concern categories, 3%, 38%, and 82% had CoA repair before initial discharge. Eighty percent of mild-concern initially remained with parents. For moderate-concern, 6/13 transferred to CICU and 5 required surgery pre-discharge. Umbilical catheters placed if CICU transfer. Conclusions A standardized risk-stratified postnatal CoA pathway can be effectively implemented in a delivery hospital and minimize medicalization of low-to-moderate-concern newborns. With appropriate safety nets, select patients can concurrently receive CoA evaluation and newborn care.

Ask AI

Helpful

Bookmark

View Full Paper