Perinatal Cardiovascular Physiology and Recognition of Critical Congenital Heart Defects

Singh, Yogen; Lakshminrusimha, Satyan

doi:10.1016/j.clp.2021.05.008

Cited by 20 publications

(10 citation statements)

References 28 publications

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“…In a review by Singh et al [3], it was suggested that timely treatment with cardiotonic drugs (e.g., prostaglandin E1) and discussion with a pediatric cardiologist could be lifesaving. Wang et al [19] recently reported an integrated approach for NICU transfer for patients with CCHD that led to shorter diagnosis and hospitalization intervals; surgery could be performed with a lower mortality risk, especially in infants with transposition of great arteries.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies showed that a prenatal diagnosis improves the prognosis of infants with CCHD [12,21,22]. Indeed, a prenatal diagnosis of CCHD will allow time for discussion with the parents, discussion among specialists [3], and planning the surgery, and the infant will be closely monitored immediately after birth. In this study, fetal ultrasound cardiac abnormality was not independently associated with survival.…”

Section: Discussionmentioning

confidence: 99%

“…Critical congenital heart disease (CCHD) is a congenital heart disease (CHD) for which the neonates require early surgical intervention to survive; otherwise, extremely high rates of mortality and survival with signi cant disability are observed [1,2]. CCHD represents approximately 25% of CHD cases [3]. The main screening methods include fetal echocardiograms and pulse oximetry [1,4,5].…”

Section: Introductionmentioning

confidence: 99%

“…A prenatal diagnosis of CCHD will improve the prognosis [12]. All cases of CCHD should be detected early and promptly discussed with a pediatric cardiologist to improve prognosis [3]. Transfer to the neonatal intensive care unit (NICU) or cardiac intensive care unit (CICU) can be lifesaving [3].…”

Section: Introductionmentioning

confidence: 99%

“…All cases of CCHD should be detected early and promptly discussed with a pediatric cardiologist to improve prognosis [3]. Transfer to the neonatal intensive care unit (NICU) or cardiac intensive care unit (CICU) can be lifesaving [3]. Studies in developed countries showed that CHD diagnosis at maternity hospitals was associated with lower healthcare costs and better prognosis [13,14].…”

Section: Introductionmentioning

confidence: 99%

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Association between specialist pediatric cardiac transfer and prognosis of neonates with critical congenital heart disease: A cohort study

Gong

et al. 2023

Preprint

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Objective: To explore whether specialist pediatric cardiac transfer could improve the prognosis of neonates with critical congenital heart disease (CCHD). Methods: This cohort study retrospectively collected the clinical data of neonates diagnosed with CCHD who underwent treatment at the cardiac intensive care unit of Shanghai Children’s Medical Center between January 2018 and December 2021. The neonates were classified into the specialist pediatric cardiac transfer (SPCT) and non-SPCT groups. Propensity score matching (PSM) was used to match the two groups. The surgical outcome was the postoperative survival of the neonates. Results: During the study period, 357 neonates with CCHD were treated and included, of which 16 died before surgery, all in the non-SPCT group. After PSM, compared with the non-SPCT group, the SPCT group showed a lower rate of inotropic drug use (57.3% vs. 77.5%, P=0.004), a lower rate of unplanned emergent operation (29.2% vs. 53.9%, p=0.001), a higher total survival rate (92.1% vs. 82.0%, p =0.044), and a lower preoperative mortality rate (0% vs. 4.5%, p =0.043). The multivariable analysis showed that body weight at surgery (HR=0.444, 95%CI: 0.273-0.711, p=0.001) and unplanned emergent surgery (HR=5.227, 95%CI: 2.521-10.834, p<0.001) were independently associated with mortality in neonates with CCHD. Conclusion:Low body weight and unplanned emergency surgery are independent risk factors for the death of neonates with CCHD. Although SPCT is unrelated to the surgery mortality rate of newborns with CCHD, it can reduce the incidence of unplanned emergency surgery and increase the total survival rate.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association between specialist pediatric cardiac transfer and prognosis of neonates with critical congenital heart disease: A cohort study

Gong

et al. 2023

Preprint

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Delivery room and early postnatal management of neonates with congenital heart disease

Ali,

Donofrio

2024

Prenatal Diagnosis

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Advancements in prenatal detection have improved postnatal outcomes for patients with congenital heart disease (CHD). Detailed diagnosis during pregnancy allows for preparation for the delivery and immediate postnatal care for the newborns with CHD. Most CHDs do not result in hemodynamic instability at the time of birth and can be stabilized following the guidelines of the neonatal resuscitation program (NRP). Critical CHD that requires intervention immediately after birth is recommended to be delivered in facilities where immediate neonatal and cardiology care can be provided. Postnatal stabilization and resuscitation for these defects warrant deviation from the standardized NRP. For neonatal providers, knowing the diagnosis of fetal CHD allows for preparation for the anticipated instability in the delivery room. Prenatal detection fosters collaboration between fetal cardiology, cardiology specialists, obstetrics, and neonatology, improving outcomes for neonates with critical CHD.

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How should we treat representative neonatal surgical diseases with congenital heart disease?

et al. 2022

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Perinatal Cardiovascular Physiology and Recognition of Critical Congenital Heart Defects

Cited by 20 publications

References 28 publications

Association between specialist pediatric cardiac transfer and prognosis of neonates with critical congenital heart disease: A cohort study

Association between specialist pediatric cardiac transfer and prognosis of neonates with critical congenital heart disease: A cohort study

Delivery room and early postnatal management of neonates with congenital heart disease

How should we treat representative neonatal surgical diseases with congenital heart disease?

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