A10. May be a role for telemedicine as well, but yes, training for those who work in higher risk areas is paramount. #FHSJClub

Jennifer Co-Vu, MD, FACC, FAAP, FASE Fetal Heart Society A6: Fetal tele-echocardiography!! Take it to the people…. #access #FHSJClub

Swati Garekar Smita Mishra; Swati Garekar you’re doing great work to improve #CHD care there! 🙏🏼 #FHSJClub

A4. In the United States 🇺🇸 ⬇️ Prenatal detection rate of #HLHS & #TGA among Hispanic moms vs non-Hispanic White moms Poss factors: 🔅⬇️ access to healthcare 🔅Language & cultural barriers 🔅Health literacy & awareness #FHSJClub

Shaine Morris MD MPH Fetal Heart Society Trust is key! 🔑 #FHSJClub

Jennifer Co-Vu, MD, FACC, FAAP, FASE Fetal Heart Society We looked at this in TX, and one reason women at the border were thought to have lower PND was some mistrust of medical providers. Alternative support like doulas can be immensely helpful, but ideally in cooperation w/ advanced prenatal care. #Buildtrust #FHSJClub

A7. Patients from Lower SES may have ⬇️ access to healthcare overall. They might not have insurance, not may have transportation issues and may not have the means to seek prenatal care, which can result to ⬇️ PND for #HLHS and #TGA, which could result to sick babies. #FHSJClub

A6. 🌆 Urban areas ⬆️ Major medical centers 🏥 with specialists (eg MFMs, #CHD doctors ) ⬆️ Access to healthcare 🟰⬆️PND 🏡 Rural areas ⬇️ Number of hospitals 🏥 ⬇️ Number of specialists 🥼 🩺 ⬆️ Distance to hospitals 🟰 ⬇️PND #FHSJClub

Jennifer Co-Vu, MD, FACC, FAAP, FASE Fetal Heart Society A8: I would love to see better communication between #OB #MFM and #fetalcardiology. A referral for “couldn’t see the heart well” sometimes means there is half a heart!! Better to talk and be on the same page… #FHSJClub

IWASHIMA Satoru岩島覚.MD, PhD.ﾔｰ Fetal Heart Society Thank you IWASHIMA Satoru岩島覚.MD, PhD.ﾔｰ for joining the #FHSJClub!

＃FHSJClub 総括 #HLHS #TGA 胎児診断 #PND in 🇺🇸 👏HLHS=92% PND and TGA=58% PND 👏ヒスパニック含む社会経済的貧困層👉lowPND と関連 👏田舎居住と公的保険も関連 ⚠️これら特定集団👉今後PND増加への取り組み重要 TGAのPNDって実は難しいﾉﾖﾈ🤔 PNDして立ち会うﾉかなりﾄﾞｷﾄﾞｷｽﾙﾈ😳

Jennifer Co-Vu, MD, FACC, FAAP, FASE Fetal Heart Society A2: Both can be #badnewsbears when not identified prenatally…. With the potential for babies to decompensate if born at hospitals without cardiology services or worse yet if they are sent home (which shouldn’t happen with #CCHD screening…. but you know…). #FHSJClub

Swati Garekar A6. Swati Garekar Why do you think this is? Is it lack of access? Poverty? Insurance? #FHSJClub

Sarah Tyler Plummer, MD FACC FAAP Fetal Heart Society #FHSJClub

Sarah Tyler Plummer, MD FACC FAAP Fetal Heart Society #FHSJClub

A9. Improving prenatal detection rates has a trickle down effect leading to reduced healthcare cost! Improved PND ➡️Better planning➡️Better preoperative outcomes➡️Good postoperative outcomes➡️Less complications ➡️Shorter hospital stay➡️ Reduce healthcare cost #FHSJClub

Jennifer Co-Vu, MD, FACC, FAAP, FASE Fetal Heart Society A9. #FHSJClub

Jennifer Co-Vu, MD, FACC, FAAP, FASE Fetal Heart Society See you👍 #FHSJClub

Thank you so much for joining us tonight at the 1st Fetal Heart Society Journal Club! Follow #FHSJClub to chime in on all 10 questions! We will post a summary of notable answers of the #FHSJClub in a few days. You will be also find them at the Fetal Heart Society website! See you every 4th

Shaine Morris MD MPH Jennifer Co-Vu, MD, FACC, FAAP, FASE Fetal Heart Society Yes, indeed👏👏👏 #FHSJClub