Article Text

Perinatal outcome of antenatally detected cardiac abnormalities delivered in a tertiary hospital
  1. S Sankaran,
  2. J Victoria,
  3. P Litha,
  4. D Irinia,
  5. S Gurleen,
  6. K Pippa
  1. Guy's and St Thomas' Hospitals NHS Trust, London, UK

Abstract

Introduction The Fetal Cardiology service at GSTT is the only service in London offering Fetal Medicine, Maternity, Neonatalology, Paediatric Cardiology and Cardiac Surgery on one site. The authors present the findings of a study of maternal and perinatal outcome for cases with antenatally detected fetal cardiac abnormalities delivered at out unit in 2008.

Materials and Methods Cases for study were identified from fetal cardiology database, specialist midwifery clinic database and maternity software (TERRANOVA) Data were obtained from individual medical records and databases. This included maternal age, referral region, onset and mode of delivery, gestational age, birth weight, cardiac diagnosis, timing and need of postnatal intervention, outcome and duration of hospital stay.

Results 107 cases were included, of whom five had chromosomal anomalies. Common antenatal diagnoses were coarctation of aorta (19.18%), hypoplastic left heart syndrome (17.92%), pulmonary atresia and transposition of great arteries (10.37% each) andtetralogy of Fallot (9.43%). The vaginal delivery rate was 60% (induction rate 58%). There were two stillbirths. Neonatal surgical intervention was required in 64 cases (60.38%), 60 (%) of these within the first 2 weeks of life. Survival rate was 71.69% in neonatal period and 66.98% at 6 months. Duration of hospital stay was 14.56±10.21 days (mean+SD) in surviving neonates and 8.727±9.5 days (mean+SD) in cases of neonatal death. Outcomes for individual conditions have been studied.

Conclusion (1) Induction rates high due to referrals from outside region. (2) LSCS rate 40% acceptable. (3) No increased maternal morbidity. (4) Surgical intervention rate 56% in first 2 weeks.

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