What is a key perinatal delivery planning consideration for fetuses with HLHS?

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Immediate, specialized postnatal care is critical for HLHS because the newborn relies on a patent ductus arteriosus for systemic blood flow and will require urgent surgical palliation within the first days of life. Delivering at a tertiary center with immediate access to pediatric cardiac surgery and NICU support ensures rapid stabilization, seamless postoperative planning, and the full range of advanced neonatal care, including maintaining ductal patency and access to ECMO if needed. This setup minimizes birth-time transfer delays and provides a coordinated, multidisciplinary team from prenatal counseling through the newborn period, which improves outcomes. Delivering at a rural hospital, at a facility without pediatric cardiac surgery, or at home would delay definitive care and markedly increase risk due to the lack of specialized resources.