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G501(P) Audit of antenatal diagnosis of congenital heart disease
  1. H Rizvi,
  2. T Hussain,
  3. S Sivakumar,
  4. V Venugopalan
  1. Neonatal Unit, City Hospital, Birmingham, UK

Abstract

Background Evidence suggests that antenatal diagnosis of major congenital heart disease (CHD) reduces mortality and morbidity rates.

Aim To look at the antenatal pick up rate for CHD compared to the postnatal diagnosis rate in a NHS Trust from 2012–2014. We aim to present our interim findings.

Method Retrospective review from January 2012 to December 2014 using:

  • Local cardiac database

  • Badger neonatal database

  • Correspondence from cardiac centres

Inclusion criteria: Babies who within the first year of life had either:

  • Cardiac surgery or

  • Catheter intervention

Exclusion criteria: Babies with either:

  • Patent ductus arteriosus

  • Patent foramen ovale

  • Atrial septal defects

Result Total of 46 cases were identified.

  • 43 babies diagnosed as inpatients.

  • 3 cases were terminations of pregnancy

  • Complete data was available for 24 patients

  • 15/27 cases were diagnosed antenatally, so detection rate of 55%

  • All terminations of pregnancy had complex cardiac disease (2 with hypoplastic left heart syndrome and 1 with complex uni ventricular heart)

  • Overall 10 VSD, 9 Arch abnormality (6 CoA, 3 hypoplastic arch) detected

  • Postnatally 6 VSD,5 arch abnormalities (3 CoA, 2 hypoplastic arch)

  • 54% post natal echoes done within the 1st day of life (13/24 cases)

  • 29% first scans on or after day 4 of life (7/24)

  • 100% antenatally diagnosed duct dependant lesion were treated with prostin

Discussion NICOR (National Institute for Cardiovascular Outcomes Research) maintains a database on the national and regional antenatal detection rate in the United Kingdom. NICOR reports that that the antenatal detection rate is improving; 42% (2012–2013)

  • Regional average 33.7% (2012–13).

  • Our findings on inpatient data suggests:

  • We have antenatal detection rate higher than the national average, even if data for the terminations of pregnancy is excluded (50%).

  • Majority of missed were diagnosed with postnatal scans within 2 days (66%) 8/12 cases

  • Arch abnormalities diagnosed after day 4 life. All cases detected antenatally were managed appropriately with Prostin.

  • Greater training is required to identify aortic arch abnormalities antenatally

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