Congenital Heart Disease in the Immediate Neonatal Period

Background: Congenital heart disease defined as an abnormality in cardio circulatory structure or function that is mostly present at birth; even it is discovered much later. Recognition of congenital heart disease in newborn is important as this group abnormality constitutes a significant proportion of congenital malformation that present in the neonatal life, and their early detection is important for appropriate management and good outcome. Objectives of present study were to evaluate clinical profile and outcome of various CHDs identified during neonatal period and to study effect of paracetamol used for pharmacological closure of PDA in preterm neonates.Methods: The study was conducted prospectively in NICU, Dhiraj hospital, Department of Pediatrics and Neonatology from January 2016 to June 2017 (1.5 years span). Echocardiography screening of all neonates suspected of having CHD was done. Details of all neonates having CHD diagnosed by echocardiography were noted in the prescribed Performa and their incidence, clinical profile and outcome was studied.Results: Total 69 cases of CHD diagnosed by Echocardiography in neonatal period were studied. Incidence of CHD among neonates born at Dhiraj hospital was 8.48 per 1000 live birth. Male: female ratio of all CHD cases was 1.38:1. Risk of neonate with CHD is highest (18.18%) in extremely low birth weight neonates. Incidence of CHD was 4.08% in preterm < 34 weeks, 3.47% in late preterms and 0.51% in full term neonates. 86.95% were diagnosed within first week of life. 26.09% babies had associated anomalies. Presenting problem of neonates was breathing difficulty 42 (60.87%), feeding difficulty 36 (52.17%) and cyanosis 5 (7.25%). 8 (11.59%) neonates were asymptomatic. The most common presenting sign was murmur 46 (75.71%). 56 (81.16%) had Acyanotic CHD and 13 (18.84%) had Cyanotic CHD. Amongst 56 (81.16%) Acyanotic CHD cases, commonest was PDA in 44 (78.5%), followed by VSD in 18 (32.14%), ASD in 5 (12.5%) either in isolation or in combination with other lesions. Amongst Cyanotic Congenital Heart Disease, maximum incidence was of Tricuspid Atresia (TA) in 4 (30.76%) cases; followed by TGA in 3 (23.07%). 20 preterm neonates with PDA received paracetamol for PDA closure. 9 (45.0%) responded to paracetamol while 11 (55%) did not respond. 47(68.12%) were discharged, 10(14.49%) went left against medical advice, 7(10.14%) were referred to higher centre for surgery and 5(7.25%) babies expired.Conclusions: Early recognition of congenital heart disease during neonatal life is important as its appropriate and timely management can result in good outcome.

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Clinical and pathogenetic features of congenital heart disease in newborns with intrauterine infection

Kazan medical journal ◽

10.17750/kmj2017-181 ◽

2017 ◽

Vol 98 (2) ◽

pp. 181-188

Author(s):

S N Beniova ◽

S Yu Figol’ ◽

O A Kornilova ◽

M L Stolina ◽

N P Blokhina

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Matrix Metalloproteinase ◽

Congenital Heart ◽

Neonatal Period ◽

Clinical Signs ◽

Intrauterine Infection ◽

Early Neonatal Period ◽

Group 2 ◽

Metalloproteinase 9

Aim. Investigation of the features of diagnosis and treatment of congenital heart disease in newborns with intrauterine herpes and cytomegalovirus infections. Methods. A comparative analysis of risk factors, clinical signs and dynamics of serum levels of matrix metalloproteinases in 91 newborns with congenital heart disease during the early neonatal period was performed. All patients were divided into 2 groups: group 1 (study group) - 51 patients with congenital heart disease and intrauterine Herpes or Cytomegalovirus infection, group 2 (comparison group) - 40 children with heart disease without the signs of intrauterine infection. The control group consisted of 20 relatively healthy full-term newborns. Results. Mothers of children with congenital heart disease and intrauterine infection more often compared to mothers of children from group 2 had inflammatory disease of reproductive system (49.1 and 22.5% respectively, р ≤0.05), medical abortions in past medical history (84.3 and 27.5% respectively, р ≤0.01), acute respiratory viral infections during pregnancy (21.6 and 7.5% respectively, р ≤0.05). Levels of matrix metalloproteinase 9 in umbilical blood plasm were statistically significantly increased in all newborns with congenital heart disease compared to control levels. The highest concentration of enzyme was registered in patients with congenital heart disease and nervous system disorders associated with intrauterine infection and in newborns with severe heart disease. Inflammatory extracardial changes in patients with congenital heart disease associated with intrauterine infection caused by Herpes Simplex virus and Cytomegalovirus were accompanied by significant increase of matrix metalloproteinase 8. Conclusion. The association between matrix metalloproteinase 9 in blood serum of newborns and clinical signs of a congenital heart disease during early neonatal period was revealed; high levels of metalloproteinase 8 can indicate intrauterine infection in newborns with congenital heart disease during early neonatal period.

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Primary Transplantation for Congenital Heart Disease in the Neonatal Period: Long-term Outcomes

The Annals of Thoracic Surgery ◽

10.1016/j.athoracsur.2019.06.022 ◽

2019 ◽

Vol 108 (6) ◽

pp. 1857-1864 ◽

Cited By ~ 2

Author(s):

Mohan M. John ◽

Anees J. Razzouk ◽

Richard E. Chinnock ◽

Matthew J. Bock ◽

Michael A. Kuhn ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Neonatal Period ◽

Long Term Outcomes

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Psychological aspects of congenital heart disease

Cardiology in the Young ◽

10.1017/s1047951100002754 ◽

1995 ◽

Vol 5 (4) ◽

pp. 302-309 ◽

Cited By ~ 5

Author(s):

Freda V. Gardner ◽

G. D. Angelini

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Neonatal Period ◽

School Age Children ◽

Psychological Care ◽

The 1960S ◽

High Level ◽

Psychosocial Morbidity ◽

The Impact

AbstractOutcome following the treatment of congenital heart disease continues to improve and interest has focused on reducing morbidity as well as mortality. One important aspect of this is the psychological effect of congenital heart disease and its treatment on both children and their parents. This review addresses the extent and nature of the psychological morbidity associated with this disease, in particular the impact of the diagnosis on the management of patient and family. The etiology of the high level of psychosocial morbidity remains poorly understood. Data from the 1960s concerned with pre-school and school-age children is now of little value given the dramatic changes in the treatment of congenital heart disease, which is now predominantly in the neonatal period. While theory from developmental and pediatric psychology may be usefully applied to this area, further research is required to define effective psychological care for patients and their families.

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