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Objective <p>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.</p> Methods <p>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).</p> Results <p>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.</p> Conclusions <p>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.</p>

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

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月8日

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  • Meghan A. Coghlan,
  • Catherine Fitt,
  • Kelli Hatter,
  • Aimen Shaaban,
  • Aaron Hamvas,
  • Sheetal R. Patel

摘要

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.