SPECTRUM OF CONGENITAL HEART DISEASE IN FULL TERM NEONATES
Abstract
Background: Congenital heart disease is a significant problem world over especially in neonates. Early diagnosis and prompt interventions in neonatal period precludes the mortality associated with this disorder. The objective of this study was to highlight the diversity of congenital cardiac defects in our region so that appropriate interventions are devised to minimize significant morbidity and mortality associated with this disorder. Methods: This descriptive cross-sectional study was conducted at the Neonatology Unit of Department of Paediatrics, Ayub Teaching Hospital from January 2015 to December 2016. Approval of ethical committee was taken. All full-term neonates of either gender who presented in department of neonatology including those delivered in hospital or received from other sources (private settings, home deliveries), diagnosed as having congenital heart disease on echocardiography were included in the study. Preterm neonates of either gender were excluded from the study. Patient characteristics were recorded in a designed proforma. Data was entered in SPSS version 20 and analysed. Results: A total of 89 neonates were included in the study. Mean age of presentation was 6.34±7.058 days and range of 1-28 days. There was a male preponderance with 57 (64%) male patients as compared to 32 (36%) female patients. Ventricular septal defect (VSD) was the commonest cardiac lesion being present in 34 (38.2%) patients. Other defects included complex congenital heart disease in 8 (9%), atrial septal defect (ASD) and transposition of great arteries (TGA) in 7 (7.9%) each, atrioventricular septal defect (AVSD) in 6 (6.7%) and Fallots's tetralogy (TOF) and hypoplastic left heart syndrome in 5 (5.6%) each. Conclusion: Congenital heart disease is a problem of profound importance. It constitutes approximately one third of the total major congenital malformations. There is a diversity of cardiac lesions in our region that warrant early and prompt interventions so that the disease is recognized and treated at the earliest to reduce morbidity and mortality.
Keywords: Congenital heart disease; ventricular septal defect; cyanotic
References
Ramegowda S, Ramachandra NB. An understanding the genetic basis of congenital heart disease. Indian J Hum Genet 2005;11(1):14-23.
van der Linde D, Konings EE, Slager MA, Witsenburg M, Helbing WA, Takkenberg JJ, et al. Birth prevalence of congenital heart disease worldwide: a systematic review and meta-analysis. J Am Coll Cardiol 2011;58(21):2241-7.
Çelik M, Aldudak B, Akar M, Akdeniz O, Tüzün H, Çelebi V. Problems of the neonates with congenital heart disease requiring early interventions: a regional report. Turk Pediatri Ars 2015;50(3):158-62.
Smitha R, Karat SC, Narayanappa D, Krishnamurthy B, Prasanth SN, Ramachandra NB. Prevalence of congenital heart diseases in Mysore. Indian J Hum Genet. 2006;12(1):11-6.
Oyen N, Poulsen G, Boyd HA, Wohlfahrt J, Jensen PK, Melbye M. Recurrence of congenital heart defects in families. Circulation 2009;120(4):295-301.
Prasad C, Chudley AE. Genetics and cardiac anomalies: the heart of the matter. Indian J Pediatr 2002;69(4):321-32.
Nisli K, Oner N, Candan S, Kayserili H, Tansel T, Tireli E, et al. Congenital heart disease in children with Down's syndrome: Turkish experience of 13 years. Acta Cardiol 2008;63(5):585-9.
Hoe TS, Chan KC, Boo NY. Cardiovascular malformations in Malaysian neonates with Down's syndrome. Singapore Med J 1990;31(5):474-6.
Hoffman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol 2002;39(12):1890-900.
Leppert M, Poisson SN, Carroll JD. Atrial Septal Defects and Cardioembolic Strokes. Cardiol Clin. 2016 May;34(2):225-30.
Page GG. Tetralogy of Fallot. Heart Lung 1986;15(4):390-401.
Waldman JD, Wernly JA. Cyanotic congenital heart disease with decreased pulmonary blood flow in children. Pediatr Clin North Am 1999;46(2):385-404.
Grifka RG. Cyanotic congenital heart disease with increased pulmonary blood flow. Pediatr Clin North Am 1999;46(2):405-25.
Huang RT, Wang J, Xue S, Qiu XB, Shi HY, Li RG, et al. TBX20 loss-of-function mutation responsible for familial tetralogy of Fallot or sporadic persistent truncus arteriosus. Int J Med Sci 2017;14(4):323-32.
Mohammad N, Shaikh S, Memon S, Das H. Spectrum of heart disease in children under 5 years of age at Liaquat University Hospital, Hyderabad, Pakistan. Indian Heart J 2014;66(1):145-9.
Wu MH, Chen HC, Lu CW, Wang JK, Huang SC, Huang SK. Prevalence of congenital heart disease at live birth in Taiwan. J Pediatr 2010;156(5):782-5.
Burki MK, Babar GS. Prevalence and pattern of congenital heart disease in Hazara. J Ayub Med Coll Abbottabad 2001;13(4):16-8.
Bhat NK, Dhar M, Kumar R, Patel A, Rawat A, Kalra BP. Prevalence and pattern of congenital heart disease in Uttarakhand, India. Indian J Pediatr 2013;80(4):281-5.
Samánek M, SlavÃk Z, Zborilová B, Hrobonová V, VorÃsková M, Skovránek J. Prevalence, treatment, and outcome of heart disease in live-born children: a prospective analysis of 91,823 live-born children. Pediatr Cardiol 1989;10(4):205-11.
Pate N, Jawed S, Nigar N, Junaid F, Wadood AA, Abdullah F. Frequency and pattern of congenital heart defects in a tertiary care cardiac hospital of Karachi. Pak J Med Sci 2016;32(1):79-84.
Patel A, Costello JM, Backer CL, Pasquali SK, Hill KD, Wallace AS, et al. Prevalence of Noncardiac and Genetic Abnormalities in Neonates Undergoing Cardiac Operations: Analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database. Ann Thorac Surg 2016;102(5):1607-14.
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