Improvement in Antenatal Diagnosis of Critical Congenital Heart Disease Implications for Postnatal Care and Screening

2011 ◽  
Vol 30 (3) ◽  
pp. 180-183 ◽  
Author(s):  
Stephanie W. Israel ◽  
Lindsay R. Roofe ◽  
Benjamin R. Saville ◽  
William F. Walsh
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Postnatal Care ◽  
Congenital Heart ◽  
Antenatal Diagnosis ◽  
Critical Congenital Heart Disease

scholarly journals Prevalência de Cardiopatias Congénitas em Portugal em 2015: Dados do Registo Nacional de Anomalias Congénitas

2020 ◽  
Vol 33 (7-8) ◽  
pp. 491
Author(s):  
Isabel Saraiva de Melo ◽  
Paula Braz ◽  
Rita Roquette ◽  
Paulo Sousa ◽  
Carla Nunes ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Anomalies ◽  
Congenital Heart ◽  
Chromosomal Abnormalities ◽  
Antenatal Diagnosis ◽  
National Registry ◽  
Critical Congenital Heart Disease ◽  
Live Births ◽  
Congenital Birth Defects

Introduction: The prevalence at birth of congenital heart disease in Portugal is 8.3/1000 births; undetected critical congenital heart disease may result in adverse outcomes for the fetus/newborn infant. This study describes the reported cases of congenital heart disease in Portugal in 2015 regarding antenatal diagnosis, cardiac defect, and presence of other congenital anomalies/chromosomal abnormalities. These indicators are compared in live births and medical pregnancy terminations. Additionally, postnatal deaths were characterized.Material and Methods: Congenital heart disease data derived from the 2015 Portuguese National Registry of Congenital Birth Defects were analyzed. The prevalence rates per 1000 births were assessed by the chi-square test of independence.Results: The prevalence of congenital heart disease in this study was 5/1000 live-births (339 live-births, 20% with critical defects). The most common defects were ventricular septal defect (38%), atrial septal defect (15%), aortic coarctation (7%), tetralogy of Fallot (7%) and pulmonary stenosis (5%). One third of the live births had antenatal diagnosis of congenital heart disease. In the live-births with critical congenital heart disease, 54% had antenatal diagnosis and 14% were diagnosed at birth. There were records of 84 pregnancy terminations; 49% had critical defects, 75% had non-cardiac congenital anomalies and 40% had chromosomal abnormalities. There were 15 postnatal deaths recorded (3.4% mortality rate), associated with prematurity/low birthweight, critical congenital heart disease, other non-cardiac congenital anomalies and chromosomal abnormalities.Discussion: The data analysis revealed a prevalence of congenital heart disease in this study of 5/1000 births (inferior to other international studies), with a distribution per type of anomaly similar to that reported in previously published work. There were significant regional differences that need further studying.Conclusion: These results are paramount to characterize the Portuguese scenario and improve Healthcare planning. It is important to improve reporting in the Portuguese National Registry of Congenital Birth Defects.

scholarly journals Pulse Oximetry Screening Has Not Changed Timing of Diagnosis or Mortality of Critical Congenital Heart Disease

2020 ◽  
Vol 41 (5) ◽  
pp. 899-904 ◽  
Author(s):  
Matthew J. Campbell ◽  
William O. Quarshie ◽  
Jennifer Faerber ◽  
David J. Goldberg ◽  
Christopher E. Mascio ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Pulse Oximetry ◽  
Congenital Heart ◽  
Critical Congenital Heart Disease ◽  
Pulse Oximetry Screening

A retrospective analysis of a pediatric tele-echocardiography service to treat, triage, and reduce trans-Pacific transport

2017 ◽  
Vol 24 (3) ◽  
pp. 224-229 ◽  
Author(s):  
Christopher A Rouse ◽  
Brandon T Woods ◽  
C Becket Mahnke
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Ductus Arteriosus ◽  
Tertiary Care ◽  
The United States ◽  
Critical Congenital Heart Disease ◽  
Medical Centers ◽  
Prompt Diagnosis ◽  
Patent Ductus

Introduction Tele-echocardiography can ensure prompt diagnosis and prevent the unnecessary transport of infants without critical congenital heart disease, particularly at isolated locations lacking access to tertiary care medical centers. Methods We retrospectively reviewed all infants who underwent tele-echocardiography at a remote 16-bed level IIIB NICU from June 2005 to March 2014. Tele-echocardiograms were completed by cardiac sonographers in Okinawa, Japan, and transmitted asynchronously for review by pediatric cardiologists in Hawaii. Results During the study period 100 infants received 192 tele-echocardiograms: 46% of infants had tele-echocardiograms completed for suspected patent ductus arteriosus, 28% for suspected congenital heart disease, 12% for possible congenital heart disease in the setting of likely pulmonary hypertension, and 10% for possible congenital heart disease in the setting of other congenital anomalies. Of these, 17 patients were aeromedically evacuated for cardiac reasons; 12 patients were transported to Hawaii, while five patients with complex heart disease were transported directly to the United States mainland for interventional cardiac capabilities not available in Hawaii. Discussion This study demonstrates the use of tele-echocardiography to guide treatment, reduce long and potentially risky trans-Pacific transports, and triage transports to destination centers with the most appropriate cardiac capabilities.

Oxygen Saturation and Perfusion Index-Based Enhanced Critical Congenital Heart Disease Screening

2019 ◽  
Vol 37 (02) ◽  
pp. 158-165 ◽  
Author(s):  
Heather Siefkes ◽  
Laura Kair ◽  
Daniel J. Tancredi ◽  
Brian Vasquez ◽  
Lorena Garcia ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Oxygen Saturation ◽  
Congenital Heart ◽  
Perfusion Index ◽  
Outflow Obstruction ◽  
Critical Congenital Heart Disease ◽  
Healthy Infants ◽  
Optimal Screening ◽  
To Come

Objective To determine if addition of perfusion index (PIx) to oxygen saturation (SpO2) screening improves detection of critical congenital heart disease (CCHD) with systemic outflow obstruction. Study Design We determined screening thresholds for PIx and applied these to a cohort of newborns with and without congenital heart disease (CHD). Results A total of 123 normal and 21 CHD newborns (including five with critical systemic outflow obstruction) were enrolled. Four of these five critical systemic obstruction subjects passed SpO2-based screen. Four out of these five subjects failed PIx-based screen. The sensitivity for detection of systemic obstruction CCHD when compared with healthy infants increased from 20% (95% confidence interval [CI]: 1–72%) with SpO2 screening alone to 80% (95% CI: 28–100%) with combined SpO2-PIx screen. However, 2.44% of normal infants failed PIx screen. Conclusion Addition of PIx to SpO2 screening may detect additional cases of CCHD and further research is necessary to come up with optimal screening thresholds.

scholarly journals Brain Injury in Infants with Critical Congenital Heart Disease: Insights from Two Clinical Cohorts with Different Practice Approaches

2019 ◽  
Vol 215 ◽  
pp. 75-82.e2 ◽  
Author(s):  
Nathalie H.P. Claessens ◽  
Vann Chau ◽  
Linda S. de Vries ◽  
Nicolaas J.G. Jansen ◽  
Stephanie H. Au-Young ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Brain Injury ◽  
Congenital Heart ◽  
Critical Congenital Heart Disease

scholarly journals Perfusion index in healthy newborns during critical congenital heart disease screening at 24 hours: retrospective observational study from the USA

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e017580 ◽  
Author(s):  
Priya Jegatheesan ◽  
Matthew Nudelman ◽  
Keshav Goel ◽  
Dongli Song ◽  
Balaji Govindaswami
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Observational Study ◽  
Oxygen Saturation ◽  
Congenital Heart ◽  
Selection Method ◽  
Perfusion Index ◽  
Data Selection ◽  
Retrospective Observational Study ◽  
Critical Congenital Heart Disease

ObjectiveTo describe the distribution of perfusion index (PI) in asymptomatic newborns at 24 hours of life when screening for critical congenital heart disease (CCHD) using an automated data selection method.DesignThis is a retrospective observational study.SettingNewborn nursery in a California public hospital with ~3500 deliveries annually.MethodsWe developed an automated programme to select the PI values from CCHD screens. Included were term and late preterm infants who were screened for CCHD from November 2013 to January 2014 and from May 2015 to July 2015. PI measurements were downloaded every 2 s from the pulse oximeter and median PI were calculated for each oxygen saturation screen in our cohort.ResultsWe included data from 2768 oxygen saturation screens. Each screen had a median of 29 data points (IQR 17 to 49). The median PI in our study cohort was 1.8 (95% CI 1.8 to 1.9) with IQR 1.2 to 2.7. The median preductal PI was significantly higher than the median postductal (1.9 vs 1.8, p=0.03) although this difference may not be clinically significant.ConclusionUsing an automated data selection method, the median PI in asymptomatic newborns at 24 hours of life is 1.8 with a narrow IQR of 1.2 to 2.7. This automated data selection method may improve accuracy and precision compared with manual data collection method. Further studies are needed to establish external validity of this automated data selection method and its clinical application for CCHD screening.

Oxygen Saturation Nomogram in Newborns Screened for Critical Congenital Heart Disease

PEDIATRICS ◽  
2013 ◽  
Vol 131 (6) ◽  
pp. e1803-e1810 ◽  
Author(s):  
P. Jegatheesan ◽  
D. Song ◽  
C. Angell ◽  
K. Devarajan ◽  
B. Govindaswami
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Oxygen Saturation ◽  
Congenital Heart ◽  
Critical Congenital Heart Disease
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