{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T09:08:47Z","timestamp":1770887327943,"version":"3.50.1"},"reference-count":18,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,7,1]]},"abstract":"<jats:p>A prenatal diagnosis of ductal-dependent, complex congenital heart disease was made in a fetus with trisomy 18. The parents requested that the genetic diagnosis be excluded from all medical and surgical decision-making and that all life-prolonging therapies be made available to their infant. There was conflict among the medical team about what threshold of neonatal benefit could outweigh maternal and neonatal treatment burdens. A prenatal ethics consultation was requested.<\/jats:p>","DOI":"10.1542\/peds.2012-3643","type":"journal-article","created":{"date-parts":[[2013,6,4]],"date-time":"2013-06-04T01:13:07Z","timestamp":1370308387000},"page":"161-165","source":"Crossref","is-referenced-by-count":30,"title":["Trisomy 18 and Complex Congenital Heart Disease: Seeking the Threshold Benefit"],"prefix":"10.1542","volume":"132","author":[{"given":"Renee D.","family":"Boss","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Johns Hopkins University School of Medicine,"},{"name":"Johns Hopkins Berman Institute of Bioethics, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn W.","family":"Holmes","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Oregon Health and Science University, Portland, Oregon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janyne","family":"Althaus","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Johns Hopkins University School of Medicine,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynda H.","family":"Rushton","sequence":"additional","affiliation":[{"name":"Johns Hopkins Berman Institute of Bioethics, and"},{"name":"Department of Acute and Chronic Care, Johns Hopkins University School of Nursing, Baltimore, Maryland; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hunter","family":"McNee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresa","family":"McNee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2013,7,1]]},"reference":[{"issue":"2 pt 1","key":"2021120900143447700_B1","first-page":"405","article-title":"Committee opinion no. 501: maternal-fetal intervention and fetal care centers.","volume":"118","author":"American College of Obstetricians and Gynecologists Committee on Ethics","year":"2011","journal-title":"Obstet Gynecol"},{"issue":"4","key":"2021120900143447700_B2","doi-asserted-by":"crossref","first-page":"395","DOI":"10.3109\/14767058.2011.580801","article-title":"Prenatal diagnosis and cesarean section in a large, population-based birth defects registry.","volume":"25","author":"Case","year":"2012","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"7","key":"2021120900143447700_B3","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1136\/medethics-2011-100340","article-title":"Survey of physicians\u2019 approach to severe fetal anomalies.","volume":"38","author":"Heuser","year":"2012","journal-title":"J Med Ethics"},{"issue":"1","key":"2021120900143447700_B4","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1097\/ANC.0b013e3181cc05bd","article-title":"Trisomy 18 and choices.","volume":"10","author":"Catlin","year":"2010","journal-title":"Adv Neonatal Care"},{"issue":"6","key":"2021120900143447700_B5","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1542\/peds.2007-1869","article-title":"Attitudes of neonatologists toward delivery room management of confirmed trisomy 18: potential factors influencing a changing dynamic.","volume":"121","author":"McGraw","year":"2008","journal-title":"Pediatrics"},{"issue":"10","key":"2021120900143447700_B6","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1089\/jpm.2010.0049","article-title":"The impact of neonatologists\u2019 religiosity and spirituality on health care delivery for high-risk neonates.","volume":"13","author":"Donohue","year":"2010","journal-title":"J Palliat Med"},{"key":"2021120900143447700_B7"},{"issue":"1","key":"2021120900143447700_B8","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1097\/ANC.0b013e3181cbf54e","article-title":"Neonatal experiences of newborns with full trisomy 18.","volume":"10","author":"Bruns","year":"2010","journal-title":"Adv Neonatal Care"},{"issue":"11","key":"2021120900143447700_B9","doi-asserted-by":"crossref","first-page":"2641","DOI":"10.1002\/ajmg.a.34285","article-title":"The impact of cardiac surgery in patients with trisomy 18 and trisomy 13 in Japan.","volume":"155A","author":"Maeda","year":"2011","journal-title":"Am J Med Genet A"},{"issue":"6","key":"2021120900143447700_B10","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1007\/s00246-009-9427-0","article-title":"Cardiac surgery in patients with trisomy 18.","volume":"30","author":"Kaneko","year":"2009","journal-title":"Pediatr Cardiol"},{"issue":"9","key":"2021120900143447700_B11","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1002\/ajmg.a.31173","article-title":"Clinical characteristics and survival of trisomy 18 in a medical center in Taipei, 1988-2004.","volume":"140","author":"Lin","year":"2006","journal-title":"Am J Med Genet A"},{"issue":"6","key":"2021120900143447700_B12","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1016\/j.amjcard.2003.12.012","article-title":"Effectiveness of cardiac surgery in trisomies 13 and 18 (from the Pediatric Cardiac Care Consortium).","volume":"93","author":"Graham","year":"2004","journal-title":"Am J Cardiol"},{"issue":"5","key":"2021120900143447700_B13","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1007\/s10897-011-9373-x","article-title":"Pediatric sub-specialist controversies in the treatment of congenital heart disease in trisomy 13 or 18.","volume":"20","author":"Yates","year":"2011","journal-title":"J Genet Couns"},{"issue":"21","key":"2021120900143447700_B14","doi-asserted-by":"crossref","first-page":"1980","DOI":"10.1056\/NEJMoa0912461","article-title":"Comparison of shunt types in the Norwood procedure for single-ventricle lesions.","volume":"362","author":"Ohye","year":"2010","journal-title":"N Engl J Med"},{"issue":"1","key":"2021120900143447700_B15","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1097\/00003246-200301000-00004","article-title":"Risk factors for long intensive care unit stay after cardiopulmonary bypass in children.","volume":"31","author":"Brown","year":"2003","journal-title":"Crit Care Med"},{"issue":"5","key":"2021120900143447700_B16","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1097\/PCC.0b013e3181fe4085","article-title":"Children with genetic disorders undergoing open-heart surgery: are they at increased risk for postoperative complications?","volume":"12","author":"Doell","year":"2011","journal-title":"Pediatr Crit Care Med"},{"issue":"6","key":"2021120900143447700_B17","doi-asserted-by":"crossref","first-page":"1689","DOI":"10.1542\/peds.2009-2222","article-title":"Policy statement\u2014physician refusal to provide information or treatment on the basis of claims of conscience.","volume":"124","author":"Committee on Bioethics","year":"2009","journal-title":"Pediatrics"},{"issue":"1","key":"2021120900143447700_B18","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1038\/sj.jp.7211860","article-title":"The health-care experiences of families given the prenatal diagnosis of trisomy 18.","volume":"28","author":"Walker","year":"2008","journal-title":"J Perinatol"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/132\/1\/161\/1102218\/peds_2012-3643.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/132\/1\/161\/1102218\/peds_2012-3643.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T05:47:47Z","timestamp":1639028867000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/132\/1\/161\/31378\/Trisomy-18-and-Complex-Congenital-Heart-Disease"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,7,1]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2013,7,1]]},"published-print":{"date-parts":[[2013,7,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2012-3643","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,7,1]]}}}