Does prenatal diagnosis of critical congenital heart diseases influence the prereferral mortality in a center without surgical intervention?

• Published in: The journal of maternal-fetal & neonatal medicine 2019-10, Vol.32 (20), p.3431-3434
• Main Authors: Özer Bekmez, Buse, Alyamaç Dizdar, Evrim, Okur, Nilüfer, Büyüktiryaki, Mehmet, Uraş, Nurdan, Oğuz, Serife Suna
• Format: Article
• Language: English
• Subjects: Adult; cardiac defect; Cardiovascular Surgical Procedures - statistics & numerical data; defect type; early detection; Female; Heart Defects, Congenital - diagnosis; Heart Defects, Congenital - epidemiology; Heart Defects, Congenital - surgery; Hospitalization - statistics & numerical data; Humans; Infant; Infant Mortality; Infant, Newborn; Intensive Care Units, Neonatal - statistics & numerical data; Male; mortality; Neonatal; Pregnancy; Prenatal Diagnosis - statistics & numerical data; Referral and Consultation - statistics & numerical data; Retrospective Studies; Time Factors; Turkey - epidemiology; Young Adult
• ISSN: 1476-7058; 1476-4954
• DOI: 10.1080/14767058.2018.1465551

Background: Prenatal diagnosis ameliorates some preoperative and postoperative outcomes in critical congenital heart disease (CHD). Despite large variability among anatomical defect types, nearly half of them are diagnosed antenatally. We aimed to investigate the effect of the antenatal diagnosis on prereferral mortality of infants with critical CHD in a center without cardiovascular surgery clinic. Methods: Medical records of the neonates who were diagnosed with critical CHD between the years 2010 and 2016 in Zekai Tahir Burak Women's health Education and Research Hospital were retrospectively reviewed for the study. Patients were divided in two groups as prenatal and postnatal regarding the time of diagnosis. Groups were compared in terms of demographical, clinical characteristics, and prereferral mortality rates. Results: Seventy seven neonates were included in the study. Of those, 39 (50%) infants had prenatal diagnosis. Most common types of CHD were tetralogy of Fallot (TOF) with pulmonary atresia, hypoplastic left heart syndrome (HLHS), and transposition of the great arteries (TGA), respectively. Demographical and clinical characteristics were similar between the groups. Minor congenital anomalies were more common in the patients with prenatal diagnosis (41 versus 18%, p = .021). Blood gas parameters were similar except pCO 2 levels, which were slightly lower in the postnatal diagnosis group (p = .048). There was no difference with regard to prereferral mortality between prenatal and postnatal diagnosed infants. Conclusions: Prenatal diagnosis may not be always associated with improved survival in critical CHD in a center without immediate surgical intervention opportunity.