{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T22:30:56Z","timestamp":1787351456773,"version":"build-2736575974"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2010,4,27]],"date-time":"2010-04-27T00:00:00Z","timestamp":1272326400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2010,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To review our experience with the prenatal diagnosis of hypoplastic left heart syndrome (HLHS). Our goal was to establish the benchmark for perinatal and early surgical outcome in the current era, from a center with an aggressive surgical approach and a cohort with a high level of intention\u2010to\u2010treat.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Outcome was assessed in fetuses with HLHS following stratification into high\u2010risk and standard\u2010risk categories. High risk was defined as the presence of any of the following: extracardiac, genetic or chromosomal anomalies; prematurity of &lt; 34 weeks' gestation; additional cardiac findings such as intact or highly restrictive atrial septum, severe degree of tricuspid regurgitation or severe ventricular dysfunction. Standard risk was defined as absence of these risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 240 fetuses evaluated over 5 years, 162 (67.5%) were in the standard\u2010risk group and 78 (32.5%) were in the high\u2010risk group. Of the 240 sets of parents, 38 (15.8%) chose termination or non\u2010intervention at birth at initial prenatal counseling and 185 of the neonates (77.1%) underwent first\u2010stage Norwood surgery with 155 surviving and 30 deaths, giving an overall Norwood operative survival of 83.8%. Breakdown by risk class reveals a significant Norwood operative survival advantage for the standard\u2010risk group (92.8%) over the high\u2010risk group (56.5%) (<jats:italic>P<\/jats:italic> &lt; 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Following prenatal diagnosis of HLHS, families should be strongly encouraged to undertake comprehensive prenatal evaluation in order to obtain an accurate prognosis. One\u2010third have additional risk factors that limit survival outcome, however two\u2010thirds do not and have an excellent chance of early survival. Copyright \u00a9 2010 ISUOG. Published by John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.7674","type":"journal-article","created":{"date-parts":[[2010,4,28]],"date-time":"2010-04-28T16:56:28Z","timestamp":1272473788000},"page":"465-470","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":102,"title":["Perinatal and early surgical outcome for the fetus with hypoplastic left heart syndrome: a 5\u2010year single institutional experience"],"prefix":"10.1002","volume":"36","author":[{"given":"J.","family":"Rychik","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Szwast","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Natarajan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Quartermain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. 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