Obstetric and Neonatal Outcomes in Congenital Isolated Cardiac Anomalies - Single Center Experience

Abstract

Objective: Evidence shows that rather than postnatal diagnoses, prenatal diagnoses of congenital heart diseases are correlated with better long-term results and lower mortality rates. In this retrospective study, neonatal stage results of infants with isolated cardiac anomalies, their indications for operation or intervention (if any), and the mortality rates in the first age are attempted to be demonstrated. Method: The study was conducted through the retrospective analysis of 47 patients who were diagnosed with fetal cardiac anomaly in the antenatal period, and monitored during natal and postnatal stages at the same center in the Departments of Obstetrics and Gynecology and Pediatric Cardiology of Dokuz Eylul University Hospital. Results: In our center 36 patients gave birth by cesarean section, and 11 patients by spontaneous vaginal delivery. Two low birthweight neonates were born (<2500 g), and these neonates were observed to have hypoplastic left heart and Fallot tetralogy. Thirty-nine of the 47 neonates born with isolated cardiac anomaly were operated after birth. Five patients were advised follow-ups. The remaining 3 neonates died within 48 hours after birth. Survival rate of the operated neonates was 59.5% and the general survival rate was 59.5%. Average 1, and 5-minute APGAR scores of the infants were 7.8 (3-9) and 9.0 (8-10), respectively The neonates were operated an average of 3 days after birth, and the average duration hospitalization of neonates were 12 days. Twentynine neonates needed preoperative respiratory support and 37 of them received prostaglandin E1 infusion. Follow-up was advised for 3 neonates within the first month and the first year. Five neonates needed operation during the specified period, and 2 neonates died. Conclusion: In conclusion, prenatal diagnosis of congenital heart diseases allows planning the delivery in tertiary care centers, stabilization of the infants in the preoperative period and realization of emergency intervention.