Natasha Henner

42 statements · 2 topics · summaries given as host listed separately

Featured statements

▶ Ep 6 · 24:10
Closing a VSD or supporting a baby with chronic mechanical ventilation may help with dyspnea, improve sleep and state regulation, improve growth, and help the child reach whatever developmental potential they were meant to reach.
clinical · Trisomy 13
▶ Ep 6 · 25:20
Prematurity, single ventricle disease, cardiopulmonary failure requiring ECMO, and cancer-directed therapy may all preclude treatment possibilities and mean a shorter life; most centers would advise against these interventions.
clinical · Trisomy 13
▶ Ep 6 · 17:30
Some decisions should be easily decoupled (mode of delivery, level of neonatal care, trial of CPAP vs. chronic mechanical ventilation), but others should be closely linked (cardiac repair with possible tracheostomy).
opinion · Trisomy 18
▶ Ep 6 · 7:00
Developmental potential in trisomy 13/18 is probably not higher than 12 to 15 months, but parents assign varied importance to this, especially when told most children die within the first year.
clinical · Trisomy 18

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Natasha's statements about Trisomy 13 21 statements

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Natasha Henner, MD - 2024 Fetal Care Center Navigating Perinatal Care for Trisomy 13 & 18

▶ Ep 6 · 4:00
epidemiological The majority of infants with trisomy 13/18 still die within the first year of life, influenced by patient phenotype, parental choice, and local institutional practices. ↗
▶ Ep 6 · 4:20
epidemiological There are higher rates of live-born infants with trisomy 13/18, and birth by C-section accounts for about 60 to 70% of all cases. ↗
▶ Ep 6 · 4:40
epidemiological With more therapies, there are more long-term survivors; surgical trends are rapidly increasing. ↗
▶ Ep 6 · 4:55
epidemiological Updated reported survival is about 40% to NICU discharge and over 25% to one year; some institutions report even higher survival. ↗
▶ Ep 6 · 6:20
opinion Futility is a flawed ethical construct and is framed by the outcomes clinicians witness. ↗
▶ Ep 6 · 7:00
clinical Developmental potential in trisomy 13/18 is probably not higher than 12 to 15 months, but parents assign varied importance to this, especially when told most children die within the first year. ↗
▶ Ep 6 · 7:25
opinion Clinician distress around trisomy 13/18 care is important but changeable and can turn into something else. ↗
▶ Ep 6 · 8:20
opinion Not acting upon something based on prognosis has an ongoing impact on that prognosis (self-fulfilling prophecy). ↗
▶ Ep 6 · 10:00
opinion If throughout medical and nursing school we learn that babies with trisomies look like malformed children in grainy pictures, we might treat them as less than human. ↗
▶ Ep 6 · 17:30
opinion Some decisions should be easily decoupled (mode of delivery, level of neonatal care, trial of CPAP vs. chronic mechanical ventilation), but others should be closely linked (cardiac repair with possible tracheostomy). ↗
▶ Ep 6 · 18:20
opinion All efforts should be made to turn surgical cardiac repair babies into long-term survivors, guided by outcomes and the overall health of each heart center. ↗
▶ Ep 6 · 21:00
quote I think we should describe the impact of the diagnosis, both short-term and long-term, when we can. I think we should talk about how babies live, not just how they die. ↗
▶ Ep 6 · 23:00
opinion It is possible that we conflate truthfulness and pessimism and are too brutal in talking about the truth, which is what parents tend to remember. ↗
▶ Ep 6 · 24:00
quote When you lead with all the things you won't do, some parents may kind of like instinctively start to fight for things they feel are unfair without a broader context. ↗
▶ Ep 6 · 24:10
clinical Closing a VSD or supporting a baby with chronic mechanical ventilation may help with dyspnea, improve sleep and state regulation, improve growth, and help the child reach whatever developmental potential they were meant to reach. ↗
▶ Ep 6 · 24:20
clinical Chronic critical illness is defined as remaining in the NICU for greater than 14 or 28 days, having chronic multi-organ conditions, or needing one or more technologies that tend to be lifelong. ↗
▶ Ep 6 · 25:15
quote Would it have been better if he died shortly after birth, and better for whom? Who should ask that question and who should answer it? My strong personal bias is that it should be his parents with us as guides and not the other way around. ↗
▶ Ep 6 · 25:20
clinical Prematurity, single ventricle disease, cardiopulmonary failure requiring ECMO, and cancer-directed therapy may all preclude treatment possibilities and mean a shorter life; most centers would advise against these interventions. ↗
▶ Ep 6 · 25:40
clinical Some places are putting kids on ECMO specifically post-cardiac repair and operating on kids with liver tumors with more successful outcomes. ↗
▶ Ep 6 · 25:45
quote I'm not certain of many things in life, but I'm certain this kid is not suffering at home. ↗
▶ Ep 6 · 28:00
quote I think when people have a sense of you being curious without having an agenda, you're just trying to learn in the beginning, they tend to open up a little bit more. ↗
Natasha's statements about Trisomy 18 21 statements

Open the Trisomy 18 collection →

Natasha Henner, MD - 2024 Fetal Care Center Navigating Perinatal Care for Trisomy 13 & 18

▶ Ep 6 · 4:00
epidemiological The majority of infants with trisomy 13/18 still die within the first year of life, influenced by patient phenotype, parental choice, and local institutional practices. ↗
▶ Ep 6 · 4:20
epidemiological There are higher rates of live-born infants with trisomy 13/18, and birth by C-section accounts for about 60 to 70% of all cases. ↗
▶ Ep 6 · 4:40
epidemiological With more therapies, there are more long-term survivors; surgical trends are rapidly increasing. ↗
▶ Ep 6 · 4:55
epidemiological Updated reported survival is about 40% to NICU discharge and over 25% to one year; some institutions report even higher survival. ↗
▶ Ep 6 · 6:20
opinion Futility is a flawed ethical construct and is framed by the outcomes clinicians witness. ↗
▶ Ep 6 · 7:00
clinical Developmental potential in trisomy 13/18 is probably not higher than 12 to 15 months, but parents assign varied importance to this, especially when told most children die within the first year. ↗
▶ Ep 6 · 7:25
opinion Clinician distress around trisomy 13/18 care is important but changeable and can turn into something else. ↗
▶ Ep 6 · 8:20
opinion Not acting upon something based on prognosis has an ongoing impact on that prognosis (self-fulfilling prophecy). ↗
▶ Ep 6 · 10:00
opinion If throughout medical and nursing school we learn that babies with trisomies look like malformed children in grainy pictures, we might treat them as less than human. ↗
▶ Ep 6 · 17:30
opinion Some decisions should be easily decoupled (mode of delivery, level of neonatal care, trial of CPAP vs. chronic mechanical ventilation), but others should be closely linked (cardiac repair with possible tracheostomy). ↗
▶ Ep 6 · 18:20
opinion All efforts should be made to turn surgical cardiac repair babies into long-term survivors, guided by outcomes and the overall health of each heart center. ↗
▶ Ep 6 · 21:00
quote I think we should describe the impact of the diagnosis, both short-term and long-term, when we can. I think we should talk about how babies live, not just how they die. ↗
▶ Ep 6 · 23:00
opinion It is possible that we conflate truthfulness and pessimism and are too brutal in talking about the truth, which is what parents tend to remember. ↗
▶ Ep 6 · 24:00
quote When you lead with all the things you won't do, some parents may kind of like instinctively start to fight for things they feel are unfair without a broader context. ↗
▶ Ep 6 · 24:10
clinical Closing a VSD or supporting a baby with chronic mechanical ventilation may help with dyspnea, improve sleep and state regulation, improve growth, and help the child reach whatever developmental potential they were meant to reach. ↗
▶ Ep 6 · 24:20
clinical Chronic critical illness is defined as remaining in the NICU for greater than 14 or 28 days, having chronic multi-organ conditions, or needing one or more technologies that tend to be lifelong. ↗
▶ Ep 6 · 25:15
quote Would it have been better if he died shortly after birth, and better for whom? Who should ask that question and who should answer it? My strong personal bias is that it should be his parents with us as guides and not the other way around. ↗
▶ Ep 6 · 25:20
clinical Prematurity, single ventricle disease, cardiopulmonary failure requiring ECMO, and cancer-directed therapy may all preclude treatment possibilities and mean a shorter life; most centers would advise against these interventions. ↗
▶ Ep 6 · 25:40
clinical Some places are putting kids on ECMO specifically post-cardiac repair and operating on kids with liver tumors with more successful outcomes. ↗
▶ Ep 6 · 25:45
quote I'm not certain of many things in life, but I'm certain this kid is not suffering at home. ↗
▶ Ep 6 · 28:00
quote I think when people have a sense of you being curious without having an agenda, you're just trying to learn in the beginning, they tend to open up a little bit more. ↗

Summaries Natasha gave as host · 8 summaries

Recaps of other experts' statements, not Natasha's own clinical position.

Summaries Natasha gave as host · Trisomy 13 4 summaries

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Natasha Henner, MD - 2024 Fetal Care Center Navigating Perinatal Care for Trisomy 13 & 18

▶ Ep 6 · 17:00
host summary Natasha Henner summarizing a resource: A 2023 consensus report states that for patients who are ventilator dependent heading into cardiovascular surgery, it is reasonable to discuss a possible risk of tracheostomy and chronic mechanical ventilation as part of counseling. ↗
▶ Ep 6 · 22:20
host summary Natasha Henner summarizing a resource: When the same outcomes were described with a survival versus a mortality frame, patients picked a different care option (citing classic cancer treatment study). ↗
▶ Ep 6 · 23:20
host summary Natasha Henner summarizing a resource: Clinicians are much more pessimistic about outcomes in almost all patient populations compared to parents, who tend to have a more positive view of the future. ↗
▶ Ep 6 · 23:40
host summary Natasha Henner summarizing a resource: Multiple data show that parents probably do not regret their decisions, so clinicians may not need to worry about it as much as they do. ↗
Summaries Natasha gave as host · Trisomy 18 4 summaries

Open the Trisomy 18 collection →

Natasha Henner, MD - 2024 Fetal Care Center Navigating Perinatal Care for Trisomy 13 & 18

▶ Ep 6 · 17:00
host summary Natasha Henner summarizing a resource: A 2023 consensus report states that for patients who are ventilator dependent heading into cardiovascular surgery, it is reasonable to discuss a possible risk of tracheostomy and chronic mechanical ventilation as part of counseling. ↗
▶ Ep 6 · 22:20
host summary Natasha Henner summarizing a resource: When the same outcomes were described with a survival versus a mortality frame, patients picked a different care option (citing classic cancer treatment study). ↗
▶ Ep 6 · 23:20
host summary Natasha Henner summarizing a resource: Clinicians are much more pessimistic about outcomes in almost all patient populations compared to parents, who tend to have a more positive view of the future. ↗
▶ Ep 6 · 23:40
host summary Natasha Henner summarizing a resource: Multiple data show that parents probably do not regret their decisions, so clinicians may not need to worry about it as much as they do. ↗