20 May 2004
Med Sci Monit 2004; 10(2): 23-27 :: ID: 11850
Background: We analyzed the group of neonates with congenital heart defects (CHD) treated in NICU between 2000-2001, with attention focused on initial diagnosis of referring neonatologist and risk factors of failure to diagnose CHD. Material/Methods: Among 1987 neonates hospitalized, 288 (14.5%) were diagnosed with CHD. The prematures with PDA were excluded from the study group. 102 (35%) patients were admitted on the first day of life, 153 (53%) between 2–7 day and the rest of them (12%) were older than 7 days. The range of birth weight was: 700–5000 grams; 32 (11%) – below 2000 g. 64 (22 %) were born prematurely. The referring neonatologist suspected CHD in 189 cases (Group A – 65.6%), the initial diagnosis in remaining patients was different (Group B).Results: The Group B patients had lower gestational age, birth weight, Apgar score, more often suffered from other diseases and multiple congenital anomalies, more frequently required intensive care procedures. Twelve Group B neonates had ductal dependent cardiac lesions. The most commonly misdiagnosed babies had ductal dependent systemic flow heart defects – 10 cases. 78 neonates (27%)required cardiac surgery. In 129 (44.8%) neonates heart defect was the only reason for hospitalization in NICU. Thirteen (4.5%) neonates died during the treatment in NICU.Conclusions: Neonates with CHDs were often referred with different initial diagnosis, which in cases with ductal dependent heart lesions created the situation of life hazard. Cardiologist consultation (with ECHO) should be one of the first procedures performed at severely ill neonate. Other diseases or organs defects in premature infants with CHDs and the necessity of multidisciplinary treatmentwere frequently connected with failure to early diagnose of CHD.
Keywords: congenital heart defect, diagnostic problems, neonate
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