Objective: To observe the effect of modified ultrafiltration on hemodynamics of pediatric patients. Study Design: A descriptive cross-sectional study. Place and Duration of Study: Pediatric Cardiac Surgery department, AFIC/NIHD Rawalpindi, from Jun 2019 to Dec 2019. Methodology: A total of 60 pediatric patients were included undergoing open-heart surgery with cardiopulmonary bypass, having age ≤6 years and weights ≤15kg. To assess hemodynamics parameters observed were pre modified ultrafiltration and post modified ultrafiltration measurements of haemoglobin level, systolic pressure, diastolic pressure, central venous pressure and the number of transfusions given after off-bypass. The data was entered and analyzed in SPSS-23. Results: The pre-operative mean Hb level of the 60 sampled patients was 12.08 ± 2.89 g/dl. The findings taken pre modified ultrafiltration and post modified ultrafiltration of haemoglobin level was (9.91 ± 0.91 g/dl and 13.09 ± 1.38 g/dl, p<0.05) after an average filtration of 370.83 ± 66.56 ml of the filtrate. The mean of systolic pressure was (61.3 ± 2.01 mmHg and 70.68 ± 1.76 mmHg, p<0.05), diastolic pressure was (49.95 ± 1.35 and 59.7 ± 6.85, p<0.005), Central Venous Pressure was (10.07 ± 1.18 and 9.9 ± 1.09, p>0.005) compared pre modified ultrafiltration and post modified ultrafiltration respectively. Conclusion: The study concluded that modified ultrafiltration has a significant impact on haemoglobin levels after bypass, decreases the allogenic transfusions and also improve the hemodynamics of the patient.

Objective: To determine the frequency of congenital cardiac lesions in pregnant women reporting for fetal echocardiogram and correlate with obstetrical risk factors. Study Design: Descriptive cross-sectional study. Place and Duration of Study: To be conducted at pediatric cardiology and obstetrical unit of AFIC/NIHD and CMH Rawalpindi, from Jan 2009 to Jan 2020. Methodology: Pregnant women referred for fetal echocardiogram from 19-49 years of age were enrolled. Echo was done between 20 to 36 weeks gestation. Primary outcome was the nature of cardiac lesion and gestation at diagnosis. Neonatal scan was done at follow up to confirm cardiac diagnosis. Secondary outcome was obstetrical risk factors which were the reason for referral. This included age consanguinity, family history, previous history of intrauterine death or early neonatal death, maternal and paternal diseases. Data was collected and analyzed n frequencies and percentage. Chi-square was applied for association between variable and p-valve 0.05 was considered significant. Results: A total of n=967 pregnant women referred to outpatient department for fetal echocardiogram. Congenital cardiac lesion were detected in n=83 patients. Majority of patients had CAVSD (1.2%) CCAVB (1.2%) followed by ASD (1.1%) VSD (0.9%) Abnormal heart rate (0.8%) Single ventricle (0.3%). Most significant maternal age group was between 21 to 30 and 30-40 years (43.7 and 46.2%). Only 3% below 20 years and 6.7% above40 years of age. Most important maternal risk factor was previous off spring 0.5% past family history 0.3% and abnormal obstetrical ultrasound 0.3% Followed by maternal diabetes 0.1% and maternal hypertension 0.1%. The yield of detection of congenital cardiac lesions was 8.3%. Conclusions: Congenital cardiac diseases are the second most common congenital anomaly and huge burden n pediatric population. Timely diagnosis and referral can be lifesaving.