Management and outcome of low birth weight neonates with congenital heart disease☆,☆☆,★
Section snippets
Patients
The following data were gathered for each infant in the study: (1) pregnancy profile (maternal age and associated medical conditions, presence and status of twin gestation, and length of gestation), (2) delivery history (type of delivery, Apgar scores at 1 and 5 minutes, need for resuscitative measures, date of birth, and birth weight), (3) preoperative status (presence of genetic aberrations, congenital anomalies, or systemic diseases [such as sepsis, renal failure, intraventricular
Pregnancy and delivery
Pregnancy was characterized by young maternal age (≤18 years of age) for 3 patients and older maternal age (≥32 years of age) for 24 patients. Associated maternal medical conditions included hypertension (n = 11), diabetes (n = 4), seizure (n = 1), and collagen vascular disease (n = 1). There were 23 twin gestations.
Of the 100 infants, 34 were delivered by cesarean section, and 66 were delivered vaginally. In 26 neonates the Apgar scores were ≤5 at 1 minute, and in 13 neonates, the scores
DISCUSSION
Although considerable progress has been made in achieving successful repair of heart disease in the neonatal period, application of this strategy of early repair to the LBW neonate has been slowed by the perception that the LBW is a risk factor in surgical intervention. A previous study indicated a high mortality rate in infants who underwent open intracardiac operations in the first 3 months of life,15 whereas we have extended our preference for corrective rather than palliative cardiac
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From the Departments of Cardiology and Cardiac Surgery, Children's Hospital, and the Departments of Pediatrics, Surgery, and Anesthesia, Harvard Medical School, Boston, Massachusetts
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Reprint requests: Anthony C. Chang, MD, Cardiac Intensive Care Office, Farley 653, The Children's Hospital, 300 Longwood Ave., Boston, MA 02115.
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0022-3476/94 $3.00 + 0 9/23/51721