Complex Congenital Heart Disease: The Influence of Prenatal Diagnosis

Detalhes bibliográficos
Autor(a) principal: Correia, Marta
Data de Publicação: 2015
Outros Autores: Fortunato, Fabiana, Martins, Duarte, Teixeira, Ana, Nogueira, Graça, Menezes, Isabel, Anjos, Rui
Tipo de documento: Artigo
Idioma: por
eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5753
Resumo: Introduction: Complex congenital heart disease is a group of severe conditions. Prenatal diagnosis has implications on morbidity and mortality for most severe conditions. The purpose of this work was to evaluate the influence of prenatal diagnosis and distance of residence and birth place to a reference center, on immediate morbidity and early mortality of complex congenital heart disease.Material and Methods:: Retrospective study of complex congenital heart disease patients of our Hospital, born between 2007 and 2012.Results:: There were 126 patients born with complex congenital heart disease. In 95%, pregnancy was followed since the first trimester, with prenatal diagnosis in 42%. There was a statistically significant relation between birth place and prenatal diagnosis. Transposition of great arteries was the most frequent complex congenital heart disease (45.2%), followed by pulmonary atresia with ventricular septal defect (17.5%) and hypoplastic left ventricle (9.5%). Eighty-two patients (65.1%) had prostaglandin infusion and 38 (30.2%)were ventilated before an intervention. Surgery took place in the neonatal period in 73%. Actuarial survival rate at 30 days, 12 and 24 months was 85%, 80% and 75%, respectively. There was no statistically significant relation between prenatal diagnosis and mortality.Discussion:: Most patients with complex congenital heart disease did not have prenatal diagnosis. All cases with prenatal diagnosis were born in a tertiary center. Prenatal diagnosis did not influence significantly neonatal mortality, as already described in other studies with heterogeneous complex heart disease.Conclusion:: prenatal diagnosis of complex congenital heart disease allowed an adequate referral. Most patients with complex congenital heart disease weren’t diagnosed prenatally. This data should be considered when planning prenatal diagnosis of congenital heart disease.
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spelling Complex Congenital Heart Disease: The Influence of Prenatal DiagnosisCardiopatias Congénitas Complexas: Influência do Diagnóstico Pré-NatalHeart DefectsCongenitalPrenatal Diagnosis.Cardiopatias CongénitasDiagnóstico Pré-natal.Introduction: Complex congenital heart disease is a group of severe conditions. Prenatal diagnosis has implications on morbidity and mortality for most severe conditions. The purpose of this work was to evaluate the influence of prenatal diagnosis and distance of residence and birth place to a reference center, on immediate morbidity and early mortality of complex congenital heart disease.Material and Methods:: Retrospective study of complex congenital heart disease patients of our Hospital, born between 2007 and 2012.Results:: There were 126 patients born with complex congenital heart disease. In 95%, pregnancy was followed since the first trimester, with prenatal diagnosis in 42%. There was a statistically significant relation between birth place and prenatal diagnosis. Transposition of great arteries was the most frequent complex congenital heart disease (45.2%), followed by pulmonary atresia with ventricular septal defect (17.5%) and hypoplastic left ventricle (9.5%). Eighty-two patients (65.1%) had prostaglandin infusion and 38 (30.2%)were ventilated before an intervention. Surgery took place in the neonatal period in 73%. Actuarial survival rate at 30 days, 12 and 24 months was 85%, 80% and 75%, respectively. There was no statistically significant relation between prenatal diagnosis and mortality.Discussion:: Most patients with complex congenital heart disease did not have prenatal diagnosis. All cases with prenatal diagnosis were born in a tertiary center. Prenatal diagnosis did not influence significantly neonatal mortality, as already described in other studies with heterogeneous complex heart disease.Conclusion:: prenatal diagnosis of complex congenital heart disease allowed an adequate referral. Most patients with complex congenital heart disease weren’t diagnosed prenatally. This data should be considered when planning prenatal diagnosis of congenital heart disease.Introdução: As cardiopatias congénitas complexas são patologias graves, e o diagnóstico pré-natal poderá ter implicações sobre a morbilidade e a mortalidade. O objetivo deste trabalho foi estudar a influência do diagnóstico pré-natal e da distância do local de parto a um centro de referência, na morbilidade imediata e mortalidade precoce de um grupo de doentes com cardiopatias congénitas complexas.Material e Métodos: Análise retrospetiva dos doentes com cardiopatias congénitas complexas, seguidos no nosso hospital, nascidos entre 2007 e 2012.Resultados: Identificaram-se 126 doentes com cardiopatias congénitas complexas. Em 95% a gravidez foi vigiada desde o primeiro trimestre existindo diagnóstico pré-natal em 42%. Houve relação estatisticamente significativa entre o local do parto e a existência de diagnóstico pré-natal. A cardiopatia congénita complexa mais frequente foi a transposição das grandes artérias (45,2%), seguida da atresia da pulmonar com comunicação interventricular (17,5%) e ventrículo esquerdo hipoplásico (9,5%). Oitenta e dois doentes (65,1%) foram medicados com prostaglandinas e 38 (30,2%) foram ventilados antes de uma intervenção. A cirurgia ocorreu no período neonatal em 73%. A sobrevida atuarial aos 30 dias, 12 e 24 meses foi 85%, 80% e 75%, respetivamente. Não houve relação estatisticamente significativa entre diagnóstico pré-natal e mortalidade.Discussão: A maioria dos doentes com cardiopatias congénitas complexas não teve diagnóstico pré-natal. Nos casos com diagnóstico pré-natal houve referenciação e parto num centro terciário. Não houve associação estatisticamente significativa entre diagnóstico prénatal e mortalidade neonatal, como já descrito em séries heterogéneas de cardiopatia congénita complexa.Conclusão: A maioria dos doentes com cardiopatias congénitas complexas não teve diagnóstico pré-natal. Estes dados devem ser tomados em conta no planeamento do diagnóstico pré-natal das cardiopatias congénitas.Ordem dos Médicos2015-04-30info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5753oai:ojs.www.actamedicaportuguesa.com:article/5753Acta Médica Portuguesa; Vol. 28 No. 2 (2015): March-April; 158-163Acta Médica Portuguesa; Vol. 28 N.º 2 (2015): Março-Abril; 158-1631646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5753https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5753/4292https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5753/4439https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5753/7541Correia, MartaFortunato, FabianaMartins, DuarteTeixeira, AnaNogueira, GraçaMenezes, IsabelAnjos, Ruiinfo:eu-repo/semantics/openAccess2022-12-20T11:04:28Zoai:ojs.www.actamedicaportuguesa.com:article/5753Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:09.468947Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Complex Congenital Heart Disease: The Influence of Prenatal Diagnosis
Cardiopatias Congénitas Complexas: Influência do Diagnóstico Pré-Natal
title Complex Congenital Heart Disease: The Influence of Prenatal Diagnosis
spellingShingle Complex Congenital Heart Disease: The Influence of Prenatal Diagnosis
Correia, Marta
Heart Defects
Congenital
Prenatal Diagnosis.
Cardiopatias Congénitas
Diagnóstico Pré-natal.
title_short Complex Congenital Heart Disease: The Influence of Prenatal Diagnosis
title_full Complex Congenital Heart Disease: The Influence of Prenatal Diagnosis
title_fullStr Complex Congenital Heart Disease: The Influence of Prenatal Diagnosis
title_full_unstemmed Complex Congenital Heart Disease: The Influence of Prenatal Diagnosis
title_sort Complex Congenital Heart Disease: The Influence of Prenatal Diagnosis
author Correia, Marta
author_facet Correia, Marta
Fortunato, Fabiana
Martins, Duarte
Teixeira, Ana
Nogueira, Graça
Menezes, Isabel
Anjos, Rui
author_role author
author2 Fortunato, Fabiana
Martins, Duarte
Teixeira, Ana
Nogueira, Graça
Menezes, Isabel
Anjos, Rui
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Correia, Marta
Fortunato, Fabiana
Martins, Duarte
Teixeira, Ana
Nogueira, Graça
Menezes, Isabel
Anjos, Rui
dc.subject.por.fl_str_mv Heart Defects
Congenital
Prenatal Diagnosis.
Cardiopatias Congénitas
Diagnóstico Pré-natal.
topic Heart Defects
Congenital
Prenatal Diagnosis.
Cardiopatias Congénitas
Diagnóstico Pré-natal.
description Introduction: Complex congenital heart disease is a group of severe conditions. Prenatal diagnosis has implications on morbidity and mortality for most severe conditions. The purpose of this work was to evaluate the influence of prenatal diagnosis and distance of residence and birth place to a reference center, on immediate morbidity and early mortality of complex congenital heart disease.Material and Methods:: Retrospective study of complex congenital heart disease patients of our Hospital, born between 2007 and 2012.Results:: There were 126 patients born with complex congenital heart disease. In 95%, pregnancy was followed since the first trimester, with prenatal diagnosis in 42%. There was a statistically significant relation between birth place and prenatal diagnosis. Transposition of great arteries was the most frequent complex congenital heart disease (45.2%), followed by pulmonary atresia with ventricular septal defect (17.5%) and hypoplastic left ventricle (9.5%). Eighty-two patients (65.1%) had prostaglandin infusion and 38 (30.2%)were ventilated before an intervention. Surgery took place in the neonatal period in 73%. Actuarial survival rate at 30 days, 12 and 24 months was 85%, 80% and 75%, respectively. There was no statistically significant relation between prenatal diagnosis and mortality.Discussion:: Most patients with complex congenital heart disease did not have prenatal diagnosis. All cases with prenatal diagnosis were born in a tertiary center. Prenatal diagnosis did not influence significantly neonatal mortality, as already described in other studies with heterogeneous complex heart disease.Conclusion:: prenatal diagnosis of complex congenital heart disease allowed an adequate referral. Most patients with complex congenital heart disease weren’t diagnosed prenatally. This data should be considered when planning prenatal diagnosis of congenital heart disease.
publishDate 2015
dc.date.none.fl_str_mv 2015-04-30
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5753/4439
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5753/7541
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dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 28 No. 2 (2015): March-April; 158-163
Acta Médica Portuguesa; Vol. 28 N.º 2 (2015): Março-Abril; 158-163
1646-0758
0870-399X
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
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