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RETROSPECTIVE ANALYSIS OF THE SPECTRUM OF CONGENITAL HEART DEFECTS IN NEWBORNS AND THE TIMING OF THEIR DIAGNOSIS

Аuthors: Ye. B. Sharhorodska, O. S. Shkolnik, H. V. Makukh, Ya. M. Korinec, N. M. Prokopchuk

Pages: 315–322

Abstract

         

Introduction. Annually more than 5.5 thousand of children with congenital heart defects are born in Ukraine. 14 % of children with cardiac anomalies die during the first week of life and 25 % of them – during the first month, and about 40 % do not survive up to 1 year. An important factor is the time of diagnosis the congenital heart defects (prenatal or postnatal), and actions to be taken.

Purpose. We are to study the structure of congenital heart defects among newborn babies, according to medical records of the Regional Clinical Hospital in Lviv during 5 years and to analyze the possibilities and the results of their prenatal diagnosis.

Materials and Methods. The analysis of health and statistical data of primary medical documentation has been done and the history cases of the 172 newborns with congenital heart diseases during 2011-2015 were analyzed. The inclusion criterion was the history of the newborn development with a clinical diagnosis of “Congenital heart disease”, according to the International Classification of Diseases -10 (Q20-Q28).

Results and Discussion. During 5 years, among 15 429 newborns 172 children were born with heart defects. The frequency of congenital heart disease was 1.1 %. It is established that in the spectrum of this disease the first place is in the structure of congenital heart defects with arteriovenous discharge of blood (“pale”) – 102 (59.6 %); the second place is taken by heart diseases with reduced or normal blood flow: 49 (28.5 %); the third – by heart diseases without discharge of blood, with the presence of obstacles at the level of the valves or major blood vessels – 14 (8.1 %). The fourth are the heart diseases that are rare – 7 (4.1 %). 28 (16.3 %) children identified concomitant congenital pathology: multiple congenital malformations – 12 (7.0 %), chromosomal disorders, 7 (4.1 %) and congenital malformations of the nervous system – 6 (3.5 %). We have set that 40.1% of the heart defects were diagnosed prenatally. In one female patient (1.5 %) heart defect was detected during the first trimester, 24 (35.8 %) – during the second trimester, 42 (62.7 %) during the third trimester of pregnancy.

Conclusions. In the structure of congenital heart defects among newborns the most common are defects with arteriovenous discharge of blood – 102 (59.6 %). 28 (16.3 %) children were born with concomitant congenital pathology, among them 7 (4.1 %) – with chromosomal pathology. According to the ultrasound prenatal diagnosis 40.1 % were diagnosed with congenital heart defects, and 59.9 % – constituted a reduction reserve of perinatal morbidity and mortality with timely diagnosis.

Keywords: congenital heart defects, prenatal diagnosis, newborn babies, retrospective analysis.

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