The Effect of Multidisciplinary Approach: A Retrospective Analysis of Congenital Heart Defects from a Tertiary Referral Centre In Bucharest-Romania

Abstract

Background: Congenital heart defects (CHD) are a common type of internal birth defect affecting newborns globally, with a prevalence ranging from 0.8% to 1.2% of all live births. CHD are a significant cause of morbidity and mortality in newborns and children worldwide. They can range in severity from simple defects to complex defects that require multiple surgeries and ongoing medical management. The mortality rate for CHD has decreased over the last decades due to improved surgical techniques and medical management. However, they still represent an important public health problem. Prenatal detection and confirmation of the diagnosis after birth, or screening of newborns suspected of having a heart anomaly, allows for early and accurate diagnosis for timely optimal care. Material and methods: We conducted a retrospective cross-sectional study, over five years (2016)(2017)(2018)(2019)(2020), at Clinical Hospital of Obstetrics and Gynecology "Prof. Dr. P. Sârbu" in Bucharest, Romania, a level III maternity hospital. Patients were selected from the hospital database. Results: We included 375 patients, identified through prenatal or neonatal screening, that had clinically diagnosed, echocardiographic confirmed, and computerized angiographyconfirmed congenital heart malformations. In our study, the incidence of congenital heart malformations was 2%. Among the identified cases, 41 had complex CHD, and 13 newborns had various genetic syndromes associated, with Down syndrome being the most common. Out of the total patients, 27 were sent to cardiovascular surgery clinics during the neonatal period. Eight patients, especially preterm infants, died due to the complicated nature of the heart malformation and other conditions. Conclusions: In CHD evaluation, there should be a multidisciplinary team involved. In our clinic, the number of newborns with CHD has increased due to effective collaboration between obstetricians, neonatologists, and pediatric cardiologists. This facilitated intrauterine transfer at any gestational age to a higher-level maternity hospital, intending to diagnose, monitor, and treat heart anomalies. Our results demonstrate the effectiveness of a multidisciplinary team and support the inclusion of a pediatric population surveillance program in the national public health strategy.