Article Text

ECHOCARDIOGRAPHIC SCREENING FOR CONGENITAL HEART DISEASE: A PILOT STUDY AND COMPARISON WITH ALTERNATE SCREENING STRATEGIES
  1. E Feil1,
  2. D Schranz2,
  3. R Hofstetter2
  1. 1Marien Hospital, Darmstadt, Germany
  2. 2Paediatric Heart Center of Hessen, Hessen, Germany

Abstract

Background and Aims Congenital heart defects (CHD) are the most common congenital malformations. Echocardiography performed by a paediatric cardiologist is regarded as the gold standard, detecting even small cardiovascular defects. The primary objective of newborn screening is the pre-symptomatic identification of life-threatening CHD in order to achieve a timely diagnosis before collapse or death occurs.

Methods Supported by the government of Hessen, and in written informed consent of the parents, a pilot study of echocardiographic (ECHO) screening was started free of charge to all babies born at the Marien-Hospital in Darmstadt since Aug 01, 2007. One experienced sonographer performed all ECHO studies with a 11 MHz transducer within the first 48 hours (median 20 hours) of neonatal life. The examination is stored as a digital video for quality management. Feasibility and expended time are regarded in this pilot study in order to transfer the structure to other maternity clinics. Comparison to clinical examination and pulse oximetry.

Results 1032 neonates (98%) could be included. The average time required for one examination was 10 minutes. 4,4% CHD (small VSD (76%), VSD>2 mm (7%), multiple VSD (7%), ASDII>5 mm (4%), AoVSt (4%), coronary-RV fistula (2%). 22% of all CHD detectable by clinical examination and 0% by pulse oximetry. Of 11% with fetal echocardography no CHF was detected prenatally. Recommended charge for this examination would be 80 euros.

Conclusions Detection rate for CHD, feasibility and calculated costs for one examination in early life are arguments which support this screening method.

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