Complex Congenital Heart Disease: The Influence of Prenatal Diagnosis

Authors

  • Marta Correia Serviço de Pediatria. Hospital Vila Franca de Xira. Vila Franca de Xira. Portugal.
  • Fabiana Fortunato Serviço de Pediatria. Hospital de Caldas da Rainha. Centro Hospitalar Oeste. Caldas da Rainha. Portugal.
  • Duarte Martins Serviço de Cardiologia Pediátrica. Hospital de Santa Cruz. Centro Hospitalar de Lisboa Ocidental. Lisboa. Portugal.
  • Ana Teixeira Serviço de Cardiologia Pediátrica. Hospital de Santa Cruz. Centro Hospitalar de Lisboa Ocidental. Lisboa. Portugal.
  • Graça Nogueira Serviço de Cardiologia Pediátrica. Hospital de Santa Cruz. Centro Hospitalar de Lisboa Ocidental. Lisboa. Portugal.
  • Isabel Menezes Serviço de Cardiologia Pediátrica. Hospital de Santa Cruz. Centro Hospitalar de Lisboa Ocidental. Lisboa. Portugal.
  • Rui Anjos Serviço de Cardiologia Pediátrica. Hospital de Santa Cruz. Centro Hospitalar de Lisboa Ocidental. Lisboa. Portugal.

DOI:

https://doi.org/10.20344/amp.5753

Keywords:

Heart Defects, Congenital, Prenatal Diagnosis.

Abstract

Introduction: Complex congenital heart disease is a group of severe conditions. Prenatal diagnosis has implications on morbidity and mortality for most severe conditions. The purpose of this work was to evaluate the influence of prenatal diagnosis and distance of residence and birth place to a reference center, on immediate morbidity and early mortality of complex congenital heart disease.
Material and Methods:: Retrospective study of complex congenital heart disease patients of our Hospital, born between 2007 and 2012.
Results:: There were 126 patients born with complex congenital heart disease. In 95%, pregnancy was followed since the first trimester, with prenatal diagnosis in 42%. There was a statistically significant relation between birth place and prenatal diagnosis. Transposition of great arteries was the most frequent complex congenital heart disease (45.2%), followed by pulmonary atresia with ventricular septal defect (17.5%) and hypoplastic left ventricle (9.5%). Eighty-two patients (65.1%) had prostaglandin infusion and 38 (30.2%)were ventilated before an intervention. Surgery took place in the neonatal period in 73%. Actuarial survival rate at 30 days, 12 and 24 months was 85%, 80% and 75%, respectively. There was no statistically significant relation between prenatal diagnosis and mortality.
Discussion:: Most patients with complex congenital heart disease did not have prenatal diagnosis. All cases with prenatal diagnosis were born in a tertiary center. Prenatal diagnosis did not influence significantly neonatal mortality, as already described in other studies with heterogeneous complex heart disease.
Conclusion:: prenatal diagnosis of complex congenital heart disease allowed an adequate referral. Most patients with complex congenital heart disease weren’t diagnosed prenatally. This data should be considered when planning prenatal diagnosis of congenital heart disease.

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Published

2015-04-30

How to Cite

1.
Correia M, Fortunato F, Martins D, Teixeira A, Nogueira G, Menezes I, Anjos R. Complex Congenital Heart Disease: The Influence of Prenatal Diagnosis. Acta Med Port [Internet]. 2015 Apr. 30 [cited 2024 Jun. 24];28(2):158-63. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/5753