Predicting Neonatal Hypoxia in dTGA/IVS Remains Challenging, Heightens Need for High-Risk Delivery Planning

Christopher Lindblade, MD, co-author of a 2026 Journal of the American Society of Echocardiography study, shares how factors seen on fetal echocardiography support the Phoenix Children’s model for performing urgent bedside balloon atrial septostomy for babies with neonatal hypoxia.

By
October 15, 2026
7 min

Phoenix Children's Medical Connection

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A prospective, multicenter study enrolled 132 mother-infant pairs with prenatally diagnosed dTGA/IVS at 23 North American institutions from 2019 to 2022.
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Third-trimester fetal echocardiographic measurements did not reliably predict neonatal hypoxia or identify infants who would remain stable after birth.
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Neonatal hypoxia occurred in 38% of infants; 61% of those infants and 51% of infants without hypoxia underwent BAS.
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The study authors said all infants with prenatally diagnosed dTGA/IVS warrant high-risk delivery planning for possible hypoxia and urgent BAS, even when fetal echocardiograms appear reassuring.
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In a separate study, bedside interventional teams reduced median time to BAS to 1.1 hours, compared with 9.3 hours after postnatal diagnosis and 4.5 hours with rapid transport.

Predicting Neonatal Hypoxia in dTGA/IVS Remains Challenging, Heightens Need for High-Risk Delivery Planning

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Original Source(s)

Predicting Neonatal Hypoxia in dTGA/IVS Remains Challenging, Heightens Need for High-Risk Delivery Planning

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