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Outcome of infants with prenatally diagnosed congenital heart disease delivered outside specialist paediatric cardiac centres
  1. Katherine Anagnostou1,
  2. Lisa Messenger2,
  3. Robert Yates3,
  4. Wilf Kelsall1
  1. 1Neonatal Intensive Care Unit, Cambridge University Hospital NHS Trust, Cambridge, UK
  2. 2Department of Obstetric Ultrasound, Cambridge University Hospital NHS Trust, Cambridge, UK
  3. 3Department of Paediatric Cardiology, Great Ormond Street Hospital for Sick Children, London, UK
  1. Correspondence to Dr Wilf Kelsall, Neonatal Intensive Care Unit, Box 226, Cambridge University Hospital NHS Trust, Hills Road, NICU BOX 226, Cambridge CB2 2QQ, UK; wilf.kelsall{at}addenbrookes.nhs.uk

Abstract

Objective To determine the outcome of neonates with a suspected antenatal diagnosis of congenital heart disease (CHD) who were delivered away from a paediatric cardiothoracic centre and were initially managed in a level 3 Neonatal Intensive Care Unit.

Methods An 18-year ongoing study conducted in a single institution.

Results Between 1992 and 2009, 143 fetuses with suspected CHD were identified, and 124 babies were delivered locally. 13 babies with a normal postnatal echocardiogram and six with isolated arrhythmias were excluded from the study. Structural CHD was confirmed in 105 infants; of these, 94 (90%) survived the neonatal period. Of the 11 neonatal deaths, only four of these infants underwent surgery; most had additional risk factors including: prematurity, very low birth weight, and genetic and other structural congenital anomalies.

Conclusions This study demonstrates that appropriately selected infants with antenatally diagnosed CHD can be safely delivered and initially managed in a non-cardiac centre during their neonatal period. Deliveries need to be carefully planned with close collaboration among neonatologists, obstetricians, paediatric cardiologists, mid-wives and parents.

  • Cardiology
  • Congenital Abnorm
  • Fetal Medicine
  • Imaging
  • Neonatology

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