title: Lack of institutional pathways for referral: results of a survey among pediatric surgeons on prenatal consultation for congenital anomalies.
abstract: OBJECTIVE
  This paper aimed to assess pathways through which pediatric surgeons receive couples for prenatal consultation after prenatal diagnosis.
  
  
  METHODS
  A questionnaire was mailed to pediatric surgical centers to assess the following: (1) surgical caseload per year; (2) number of centers in which prenatal consultation is offered; (3) presence of a 'structured' prenatal consultation clinic; (4) number of consultations per year; (5) pathways for referral to the pediatric surgeon; and (6) the availability of psychological counseling.
  
  
  RESULTS
  Response rate was 81%, (42/52 centers). Thirty-eight centers (93%) offered prenatal consultation. Seven centers (18%) reported to have a 'structured' clinic in terms of time and location. In 13 centers (34%), 1-9 consultations were carried out, from 10 to 19 in 18 centers (47%), from 20 to over 50 in 7 centers (18%). In 34 centers, internal referrals from the obstetric departments were counseled, and in 28 centers, there were also external referrals. Eleven centers reported that couples were self-referred. Information regarding prenatal counseling was available on the institutional website in 10/38 (26%) centers. Psychological counseling was available in 36 centers.
  
  
  CONCLUSIONS
  Despite the fact that the majority of pediatric surgical centers provides prenatal consultation, caseloads are very variable as are referral modalities.
authors.affiliation: Medical and Surgical Neonatal Department, Bambino Gesù Children's Hospital, P.zza S. Onofrio, 4, Rome, 00165, Italy. aite@opbg.net
authors.forename: Lucia
authors.initials: L
authors.lastname: Aite
authors.forename: Antonio
authors.initials: A
authors.lastname: Zaccara
authors.forename: Marina
authors.initials: M
authors.lastname: Cuttini
authors.forename: Nadia
authors.initials: N
authors.lastname: Mirante
authors.forename: Antonella
authors.initials: A
authors.lastname: Nahom
authors.forename: Pietro
authors.initials: P
authors.lastname: Bagolan
mesh_terms: D002648:Child; D000013:Congenital Abnormalities / Q000175:diagnosis* / Q000601:surgery*; D003266:Continuity of Patient Care / Q000458:organization & administration; D003376:Counseling / Q000706:statistics & numerical data; D019091:Critical Pathways / Q000458:organization & administration*; D005260:Female; D006801:Humans; D010372:Pediatrics / Q000458:organization & administration*; D010820:Physicians; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012017:Referral and Consultation / Q000458:organization & administration*; D013514:Surgical Procedures, Operative; D011795:Surveys and Questionnaires