Prevention of delayed diagnosis in congenital heart disease

Wacker-Gußmann, Annette; Ehringer-Schetitska, Doris; Herceg-Čavrak, Vesna; Hidvégi, Erzsébet Valéria; Jakab, Andrea Emese; Petropoulos, Andreas; Jokinen, Eero; Fritsch, Peter; Oberhoffer, Renate

doi:10.1017/s1047951119000064

Cited by 4 publications

(5 citation statements)

References 7 publications

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“…In this current study, the proportion of CCHD newborns identified as the result of a delayed diagnosis was 2.97% (55 of 1851 patients), which was lower than that reported in the US and other countries (4.3–22.9%). 2 , 3 , 6 – 9 The multivariate logistic regression analysis of the potential risk factors associated with mortality in live birth newborns (considering the exclusion criteria) showed that the gestational age of premature infants was the only risk factors for newborn death within the first week after birth. It was reported that the gestational age of premature infants, with a weight of < 2500 g, was a risk factor for CCHD-related death.…”

Section: Discussionmentioning

confidence: 99%

“…Systematic statistical analysis of CCHD diagnosis and outcomes has been undertaken in the US and other countries. 2 , 3 , 6 – 9 In the US, suspected CCHD cases are usually screened out from newborns within 24–48 h of birth through the combination of percutaneous oximetry and prenatal ultrasound. 6 , 7 Neonatal percutaneous oximetry provides a reliable approach for the precise diagnosis of CCHD, which eventually decreases the risk of newborn mortality.…”

Section: Introductionmentioning

confidence: 99%

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Delayed diagnosis of critical congenital heart defects predicting risk factors and survival rate in newborns in Beijing: a retrospective study

Zhang

et al. 2021

J Int Med Res

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Objective To assess the prevalence and survival rate of newborns with a delayed diagnosis of critical congenital heart defects (CCHD) in Beijing. Methods This retrospective study analysed data from births between 2010 and 2017 from the Birth Defects Monitoring Network in Beijing. Newborns with CCHD were analysed according to seven categories. Statistical analyses were used to calculate the mortality rate within the first week (days 0–6) after live birth. Multivariate logistic regression analysis of survival was performed to analyse the potential risk factors for newborn mortality. Results A total of 1 773 935 perinatal newborns were screened in Beijing and 1851 newborns were diagnosed with CCHD, showing a prevalence of 10.43 per 10 000. Among the total 1851 CCHD patients, the majority (1692 of 1851; 91.41%) were identified through prenatal diagnosis, 104 of 1851 (5.62%) were diagnosed before obstetric discharge/transfer and 55 of 1851 (2.97%) were identified through delayed diagnosis. The prevalence of CCHD in newborns was 1.96 per 10 000 births. Multivariate logistic regression analysis of survival demonstrated that gestational age at delivery was the only risk factor for death within the first week after birth. Conclusions Within the first week after birth, gestational age was the only risk factor for death in newborns with CCHD.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Delayed diagnosis of critical congenital heart defects predicting risk factors and survival rate in newborns in Beijing: a retrospective study

Zhang

et al. 2021

J Int Med Res

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“…La detección prenatal depende de la disponibilidad de equipos de ecografía, de la capacitación y derivación apropiada a especialistas 12 . Actualmente, el diagnóstico prenatal de malformaciones cardíacas congénitas fetales en manos expertas es del 90-100% 3 .…”

Section: Discussionunclassified

“…El diagnóstico prenatal permite la coordinación multidisciplinaria para que estos pacientes nazcan en un centro con experiencia en el manejo de esta patología, permitiendo optimizar la condición neonatal preoperatoria, disminuyendo la morbilidad y letalidad 5,8 . Se ha descrito que los pacientes con diagnóstico prenatal de SCIH presentan menor incidencia de falla cardíaca y de otros órganos, menor conexión a VMI, uso de antimicrobianos, necesidad de apoyo vasoactivo y de cirugía de urgencia 12 .…”

Section: Discussionunclassified

Diagnóstico prenatal y manejo neonatal precoz de pacientes con Síndrome de corazón izquierdo hipoplásico: experiencia de un centro perinatal

et al. 2021

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El Síndrome de Corazón Izquierdo Hipoplásico (SCIH) es la forma más común de ventrículo único. A pesar de los avances médico-quirúrgicos, la morbimortalidad se mantiene elevada, especialmente alrededor de la primera cirugía en el período neonatal.Objetivo: Describir las características clínicas de recién nacidos con SCIH, atendidos en un Centro de Derivación perinatal.Pacientes y Método: Estudio retrospectivo descriptivo de todos los recién nacidos con diagnóstico pre y/o postnatal de SCIH entre 2014-2019 en el Complejo Asistencial Dr. Sótero del Río. Se revisaron los registros médicos recolectando las variables demográficas, perinatales, evolución clínica, letalidad asociada a la primera cirugía y sobrevida al año.Resultados: Se incluyeron 19 pacientes. La mayoría fueron recién nacidos de término y 13/19 de sexo femenino. Todos tenían diagnóstico prenatal de SCIH. Cinco pacientes presentaron malformaciones extracardiacas. De los 19 pacientes, 16 requirieron apoyo vasoactivo y 17 conexión a ventilación mecánica invasiva. Siete recibieron estímulo enteral, sin episodios de enterocolitis. La mediana de edad del traslado al centro cardioquirúrgico fue a los 8 días. Trece pacientes fueron sometidos a la cirugía de Norwood-Sano, con una letalidad de un 31% y una sobreviva al año de vida de 47%.Conclusiones: El manejo neonatal de pacientes con SCIH es complejo y el enfrentamiento intensivo y multidisciplinario es fundamental. La letalidad alrededor de la primera etapa quirúrgica de nuestra cohorte es mayor que los reportes internacionales y podrían estar influyendo la ausencia de terapia fetal y la mayor incidencia de malformaciones extracardiacas.

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“…Subsequently, preterm birth has been the most common cause of death in early life (3). Some survivors of preterm birth were afflicted by prematurity-associated complications and sequelae in childhood and/or adulthood, such as developmental retardation, bronchopulmonary dysplasia (BPD) and congenital heart disease (CHD) (4)(5)(6)(7). Moreover, population-based epidemiological data have shown close association between growth and development in early life and health and disease in childhood and/or as adults.…”

Section: Introductionmentioning

confidence: 99%

Ten-Year Multi-Center Survey of Infant Mortality in China

Chen¹,

Zhu²,

Shi³

2019

Iran J Pediatr

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Background:The neonatal mortality rate has continually decreased over time; however, some surviving infants may die after the neonatal period due to complications. Objectives: Objective of this study was to provide evidence to support more medical care for infants during the post-neonatal period (> 28 days to < 100 days after birth). Methods: Multi-center retrospective survey. Fourteen hospitals in china between January 1, 2004 and December 31, 2013. A total of155463 infants aged 0 -1 year were enrolled in the survey. Among them, 959 died. Data from hospitalized infants younger than 1 year of age were collected. Mortality and its etiology during the neonatal, post-newborn, and modified infant (100 days to 1 year) period were evaluated. Results: The total infant mortality was 6.16%. Significant differences were found in the mortality rate in the three periods (10.1% vs 6.9% vs 2.6%, P = 0.000). The three main causes of death were pneumonia, congenital heart disease (CHD), and premature-associated disease (PAD) during the post-newborn period. Moreover, four major diseases simultaneously occurring during the three periods (PAD, pneumonia, sudden infant death syndrome, and CHD) showed an inverse "U" shape change from the neonatal period to the modified infant period, with the highest mortality rate occurring during the post-newborn period (P < 0.001). Conclusions: Differences in mortality and the associated etiology during early life indicate that more medical attention should be paid to the post-newborn period. Further study is needed to better understand its clinical significance.

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Prevention of delayed diagnosis in congenital heart disease

Cited by 4 publications

References 7 publications

Delayed diagnosis of critical congenital heart defects predicting risk factors and survival rate in newborns in Beijing: a retrospective study

Delayed diagnosis of critical congenital heart defects predicting risk factors and survival rate in newborns in Beijing: a retrospective study

Diagnóstico prenatal y manejo neonatal precoz de pacientes con Síndrome de corazón izquierdo hipoplásico: experiencia de un centro perinatal

Ten-Year Multi-Center Survey of Infant Mortality in China

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