Prevention and Early Detection of Congenital Heart Defects. Where do we stand.

2021 ◽  
Vol 1 (4) ◽  
pp. 1-6
Author(s):  
Andreas Petropoulos
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Early Detection ◽  
Pulse Oximetry ◽  
Congenital Heart Defects ◽  
Screening Test ◽  
Congenital Heart ◽  
Heart Defects ◽  
Maternal Risk ◽  
Prevention And Early Detection

Introduction: Since the origin of Medicine in 4th BC. Century research has taught us that learning and practicing preventive medicine is properly the best method to prevent disease from happening in the first place. Preventive health care must be planned and executed ahead of time, even when illness/ disease, is absent, especially for those that are common and fаtal. Among neonates and infants, congenital heart disease (CHD) is responsible for the largest proportion of mortality caused by birth defects. Actual numbers of patients and mortality resulting from CHD reportedly is increasing. In the developed world the treatment of CHD has escalating costs for health care systems and private covered patients, while in low-income countries it is not always available. Prevention is urgently needed to tackle the increasing needs. Aim: To present the current practice in preventing/early detecting CHD and justify why pulse oximetry is the best available, early detecting postnatal screening test we currently have. Methods: The existing in use preventing/early detecting methods for avoiding or early diagnosing CHD are: 1. Eliminate the maternal risk factors by obtaining a good level of health and medical surveillance during pregnancy. 2. Avoiding teratogenic agents, 3. Detecting risk factors from Family History, 4. Delivering a balanced Nutrition during Pregnancy 5. Obtaining at least an experienced 4-chamber view and outflow tracts imaging during the 20-weeks anomaly scan. 6. Fetal Echocardiography when indicated 7. Postnatal evaluation by experienced Pediatricians. 8. Pulse Oximetry, screening test after 72 hours post-delivery in term babies. 9. Hyperoxia test when indicated. Conclusion: Although CHD’s are the most common, high morbidity and mortality, congenital malformations, we still lack a single, easy to apply, non-invasive and low-cost screening test, for early detection. The current preventive methods must be combined to counterbalance the CHD prevalence. Meanwhile, they are costly and partially accessible. The most advantageous method for minimizing CHD deaths worldwide seems to be currently, pulse oximetry combined with clinical assessment. Original publication: Petropoulos AC. Prevention and Early Detection of Congenital Heart Defects. Where do we Stand. J Cardiol 2018, 2(1): 000111.

Prevention and Early Detection of Congenital Heart Defects. Where do we stand.

2018 ◽  
Vol 1 (5) ◽  
pp. 1-6
Author(s):  
Andreas Petropoulos
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Early Detection ◽  
Pulse Oximetry ◽  
Congenital Heart Defects ◽  
Screening Test ◽  
Congenital Heart ◽  
Heart Defects ◽  
Maternal Risk ◽  
Prevention And Early Detection

Introduction: Since the origin of Medicine in 4th BC. Century research has taught us that learning and practicing preventive medicine is properly the best method to prevent disease from happening in the first place. Preventive health care must be planned and executed ahead of time, even when illness/ disease, is absent, especially for those that are common and fаtal. Among neonates and infants, congenital heart disease (CHD) is responsible for the largest proportion of mortality caused by birth defects. Actual numbers of patients and mortality resulting from CHD reportedly is increasing. In the developed world the treatment of CHD has escalating costs for health care systems and private covered patients, while in low-income countries it is not always available. Prevention is urgently needed to tackle the increasing needs. Aim: To present the current practice in preventing/early detecting CHD and justify why pulse oximetry is the best available, early detecting postnatal screening test we currently have. Methods: The existing in use preventing/early detecting methods for avoiding or early diagnosing CHD are: 1. Eliminate the maternal risk factors by obtaining a good level of health and medical surveillance during pregnancy. 2. Avoiding teratogenic agents, 3. Detecting risk factors from Family History, 4. Delivering a balanced Nutrition during Pregnancy 5. Obtaining at least an experienced 4-chamber view and outflow tracts imaging during the 20-weeks anomaly scan. 6. Fetal Echocardiography when indicated 7. Postnatal evaluation by experienced Pediatricians. 8. Pulse Oximetry, screening test after 72 hours post-delivery in term babies. 9. Hyperoxia test when indicated. Conclusion: Although CHD’s are the most common, high morbidity and mortality, congenital malformations, we still lack a single, easy to apply, non-invasive and low-cost screening test, for early detection. The current preventive methods must be combined to counterbalance the CHD prevalence. Meanwhile, they are costly and partially accessible. The most advantageous method for minimizing CHD deaths worldwide seems to be currently, pulse oximetry combined with clinical assessment. Original publication: Petropoulos AC. Prevention and Early Detection of Congenital Heart Defects. Where do we Stand. J Cardiol 2018, 2(1): 000111.

Maternal risk factors for congenital heart defects in infants with Down syndrome from Western Mexico

2019 ◽  
Author(s):  
Jorge Román Corona‐Rivera ◽  
Rafael Nieto‐García ◽  
Andrea S. Gutiérrez‐Chávez ◽  
Lucina Bobadilla‐Morales ◽  
Izabel M. Rios‐Flores ◽  
...  
Keyword(s):  
Risk Factors ◽  
Down Syndrome ◽  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Heart Defects ◽  
Maternal Risk Factors ◽  
Maternal Risk ◽  
Western Mexico

scholarly journals Pulse Oximetry During the First 24 Hours as a Screening Tool For Congenital Heart Defects

2017 ◽  
Vol 3 (1) ◽  
pp. 12-17
Author(s):  
Mihaela Patriciu ◽  
Andreea Avasiloaiei ◽  
Mihaela Moscalu ◽  
Maria Stamatin
Keyword(s):  
Oxygen Saturation ◽  
Pulse Oximetry ◽  
Sensitivity And Specificity ◽  
Congenital Heart Defects ◽  
Screening Test ◽  
Congenital Heart ◽  
Heart Defects ◽  
Blood Oxygen ◽  
Blood Oxygen Saturation ◽  
Routine Pulse Oximetry

Abstract Introduction: Although screening for congenital heart defects (CHD) relies mainly on antenatal ultrasonography and clinical examination after birth, life-threatening cardiac malformations are often not diagnosed before the patient is discharged. Aim: To assess the use of routine pulse oximetry in the delivery room and at 24 hours postpartum, and to study its feasibility as a screening test for CHD. Material and Methods: In this prospective study, all infants born in “Cuza Voda” Maternity Hospital, Iasi, Romania, were enrolled over a thirteen-month period. Preductal oximetry was assessed during the first hour, and postductal oximetry was evaluated at twenty-four hours postpartum. Data were then analyzed to establish the sensitivity and specificity of pulse oximetry, as a screening test for CHD. Results: 5406 infants were included in the study, with a mean gestational age of 38.2 weeks and a mean birth weight of 3175 grams. During the first minute, blood oxygen saturation varied between 40% and 90% and at 24 hours of life, it ranged between 90% and 100%. Following oximetry assessment, 14 infants with critical CHD were identified. Blood oxygen saturation values in infants with CHD were lower throughout the entire period of evaluation. Pulse oximetry had good sensitivity and specificity at 1 hour (Se=87.5%, Sp=95.5%) and 24 hours (Se=92.5%, Sp=97.4%) for the diagnosis of CHD. Blood oxygen saturation values at one minute, 1 hour and 24 hours are strong discriminative parameters for the early diagnosis of CHD. Conclusion: Routine pulse oximetry during the first 24 hours postpartum represents an early indicator of CHD to facilitate timely intervention. Pulse oximetry provides excellent sensitivity and specificity and has tremendous potential as a standard screening test for CHD during the first 24 hours of life.

Pulse oximetry as a screening test for congenital heart defects in newborn infants: the pulseox test accuracy study

2011 ◽  
Vol 96 (Supplement 1) ◽  
pp. Fa3-Fa3
Author(s):  
L. J. Middleton ◽  
A. K. Ewer ◽  
A. Bhoyar ◽  
A. T. Furmston ◽  
J. P. Daniels ◽  
...  
Keyword(s):  
Pulse Oximetry ◽  
Congenital Heart Defects ◽  
Screening Test ◽  
Congenital Heart ◽  
Heart Defects ◽  
Newborn Infants ◽  
Test Accuracy ◽  
Accuracy Study

Risk factors for congenital heart defects in two populations residing in the same geographic area: a long-term population-based study, Southern Israel

2019 ◽  
Vol 29 (8) ◽  
pp. 1040-1044 ◽  
Author(s):  
Renana Robinson ◽  
Moshe Stavsky ◽  
Maayan Yitshak Sade ◽  
Hanah Krymko ◽  
Leonel Slanovic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Heart Defects ◽  
Geographic Area ◽  
High Rate ◽  
Structural Defects ◽  
In Vitro Fertilisation ◽  
Maternal Risk ◽  
Total Prevalence

AbstractBackground:Congenital Heart Defects (CHD) are the most common structural defects of newborns. Southern Israel’s population is comprised of Jews (75%) and Arab-Bedouins (25%). The latter has a high rate of consanguinity and low abortion rate compared with the Jewish population, which led us to suspect a higher CHD prevalence in this population. Our aim was to compare maternal risk factors that are associated with CHD in these populations.Methods:All births during 1991–2011 in Soroka University Medical Center (n = 247, 289) with 6078 newborns having CHD were included. To account for same-woman deliveries, general estimating equation models adjusted for ethnicity, gender and birth number were used.Results:The total prevalence of CHD was 24.6/1000 live births, with 21.4 and 30 among Jewish and Bedouin populations, respectively, (p = 0.001). Multi-variant analysis of risk factors for CHD revealed that risk factors common to both populations included conception with fertility medications, sibling CHD, maternal CHD, diabetes mellitus, hypertension and anaemia. Risk factors that were specific for the Bedouin population were – maternal age over 35 years, recurrent pregnancy loss and in vitro fertilisation. However, sibling CHD was more common as a CHD risk factor in the Jewish compared with the Bedouin population (Adjusted OR 10.23 versus 3.19, respectively).Conclusions:The prevalence of CHD is higher in both the Bedouin and Jewish populations than previously reported. Several maternal factors were associated with CHD specifically for a certain population. Risk factors for CHD vary in populations residing in the same geographic area.

Evaluation of C677T and A1298C polymorphisms of theMTHFRgene as maternal risk factors for Down syndrome and congenital heart defects

2009 ◽  
Vol 149A (10) ◽  
pp. 2080-2087 ◽  
Author(s):  
Ana Paula Carneiro Brandalize ◽  
Eliane Bandinelli ◽  
Pollyanna Almeida dos Santos ◽  
Israel Roisenberg ◽  
Lavínia Schüler-Faccini
Keyword(s):  
Risk Factors ◽  
Down Syndrome ◽  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Heart Defects ◽  
Maternal Risk Factors ◽  
Maternal Risk

P2579Experience of application in Russia pulsoxymetry as screening for detecting critical states in the newborns: critical congenital heart defects and pulmonary hypertension

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
N Kustova ◽  
D R Sadykova ◽  
D R Sabirova ◽  
A A Babintseva
Keyword(s):  
Pulmonary Hypertension ◽  
Early Detection ◽  
Pulse Oximetry ◽  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Heart Defects ◽  
Decisive Role ◽  
Persistent Pulmonary Hypertension ◽  
Critical Conditions ◽  
Maternity Hospitals

Abstract Despite the improvement in the last decades of prenatal ultrasound diagnosis and clinical examination of newborns, even in countries with developed health care, up to 28% of newborns with critical congenital heart defects (CHD) are discharged from the hospital without a diagnosis. Early detection of persistent pulmonary hypertension in newborns (PPHN) is often associated with certain difficulties, which leads to a delayed diagnosis of this syndrome and a later start of therapy. Objective To improve the methods of diagnosing the early detection of newborns with hypoxemia due to critical CHD or persistent pulmonary hypertension of the newborn, as well as to achieve a reduction in infant mortality. Materials and methods During the study period – from April 2017 to February 2018 using the developed algorithm for performing screening of critical conditions in newborns using pulse oximetry, 8,358 newborns were examined on the basis of maternity hospitals of the Republic of Tatarstan, which accounted for 88.4% of 9459 births registered. A modified two-band pulse oximetry technique was used, followed by echocardiography of the newborn with a positive screening result. Results The introduction of pulse oximetry screening in the early neonatal period (3rd hour of life) allowed the timely detection of 95 children with a positive test result, whose conditions caused the greatest risk to the health of newborns, which accounted for 1.14% of all children studied. Thanks to the screening, in 13 newborns in the first hours of life, congenital heart defects that were not diagnosed in utero were detected, 5 of them were critical. Persistent pulmonary hypertension was detected in 20 patients. Intrauterine pneumonia was diagnosed in 30 newborns. Among the critical CHDs, the following diagnoses were established: transposition of the great vessels – 2 children, aortic coarctation – 1 child, total abnormal pulmonary vein drainage – 1 child, Taussin-Bing anomaly – 1 child. Evaluation of the effectiveness of the screening showed that a positive result had a decisive role in the timely diagnosis of critical CHD and persistent pulmonary hypertension of the newborn. Conclusions Pulse oximetry helps to identify both systemic hypoxemia and postductal desaturation, which is characteristic of both critical CHD and PPHN, and can be used to screen newborns for these conditions. Pulse oximetry is an easily accessible, non-invasive, painless method that can be included in a regular examination of the newborn. The advantages of pulse oximetry also include simplicity and short procedure time.

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