# Re-evaluating a Prenatal Do Not Attempt Resuscitation Order in a Neonate With Ebstein’s Anomaly: A Case Report Highlighting Ethical Flexibility in Neonatal Care

## TL;DR

A newborn with a rare heart defect initially had a DNAR order, but postnatal stability led to a reversal, emphasizing the need for flexible ethical decisions in neonatal care.

## Contribution

This case report demonstrates ethical flexibility and the value of re-evaluating neonatal care decisions based on evolving clinical conditions.

## Key findings

- The neonate's postnatal stability contradicted the prenatal prognosis, prompting a reversal of the DNAR order.
- Dynamic assessment and multidisciplinary collaboration were critical in re-evaluating the neonate's care plan.
- The case underscores the importance of ethical considerations in neonatal decision-making.

## Abstract

Ebstein’s anomaly is a rare congenital heart defect with a variable prognosis. This report presents a male neonate with a prenatal do not attempt resuscitation (DNAR) order due to a presumed poor prognosis from complex congenital heart disease (CHD). Unexpected postnatal stability led to a re-evaluation of the diagnosis and the reversal of the DNAR status to full support. This case highlights the importance of dynamic assessment, multidisciplinary collaboration, and ethical consideration in neonatal care decisions.