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Aims: To identify the annual incidence of congenital heart disease (CHD) in our population and to assess the pick up rate during antenatal ultrasound. Methods:Retrospective analysis of cases diagnosed with CHD between January 2007 -April 2010.Results: Forty-four cases of CHD were diagnosed during the study period. Of these, 19 cases were diagnosed antenatally and 25 cases postnatally. Of the19 cases: 7 four-chamber anomalies  7 out-flow tract anomalies and  5 cases of cardiomegaly 5 cases were terminated [associated with syndromes], 2 resulted in miscarriages, 5 suffered neonatal deaths and 7 survived (survival rate-37%). Of the 25 cases diagnosed postnatally:Twenty babies were term deliveries and 5 were pre-term. 16-cases (64%) were diagnosed within the 1 st month of delivery. Eight (32%) of the 25 cases were cyanotic CHD.Following are the specific diagnosis of postnatal CHD. Transposition of great arteries-4  Aortic stenosis-1  Pulmonary stenosis-5  Septal defects-7  Ebstein anomaly-1  Tetralogy of Fallot-3  Coarctation of aorta-2  Dextrocardia-1  Coronary artery fistula-1 16-cases were treated with surgical corrections and 9-cases treated conservatively. 24-neonates survived (survival rate-96%). Conclusion:Annual incidence rate of CHD in our population was 1.4% with 43% of cases identified during antenatal scans. Following the audit, following measures have been introduced.  Merging antenatal cardiac clinics and paediatric cardiac clinics  "Tiny Tickers"-The Regional Foetal Cardiac Training Group for the Ultrasonographers are introducing a training program.

Aims To assess the nutritional status of infants with congenital heart disease (CHD) who were managed jointly by the medical and dietetic teams and required either high calorie feeds or nasgastric feeding to optimise their growth. Methods Infants with CHD requiring dietetic input between 2008–2011 were reviewed. Patients were identified from paediatric cardiac and dietitians databases. A retrospective case note and electronic clinic letter review was performed. Results Thirty nine infants were studied: 15(39%) with cyanotic CHD and 24(61%) acyanotic CHD. In 12 (29%) cases CHD was part of a syndrome. 25(64%) were treated surgically, 8(21%) required transcatheter procedures and 6(15%) were managed medically. Surgery was performed in 9 (27%) within 1-month of their birth and 24(73%) within the first-year.10 (67%) of the cyanotic infants had their corrective surgeries in the first 6 months. All 6 (15%) managed medically were among the acyanotic infants, 19 (76%) of the acyanotic infants were on diuretics and 10(40%) were operated in the later half of the year. There were 4 (10%) deaths in this cohort. The birthweight was less than the 2nd centile in 12% of infants and overall 67% had a birthweight less than 50th centile. In the pre-operative period, 14(41%) were nasogastric fed (NG). The majority of infants were on mixed feeds, 50% receiving some breast milk and 65% receiving Infatrini to maximise the weight gain. In the post-operative period, 10(30%) needed nasogastric feeds and 3(8%) with complex gut anomalies needed gastrostomy feeding tubes. The NG tubes were in place post-operatively for a median period of 2 months. At the end of 1 year, there was improvement in weight gain in 8(53%) of the cyanotic infants and 9(38%) of the acyanotic infants. Conclusion Challenges persist in optimising the nutritional needs especially in children with CHD particularly those on prolonged diuretics. Collaboration with the dieticians is essential for optimising their growth prior to and after surgery.