Objective:To determine outcome of delivery before 36 weeks gestation in babie s diagnosed antenatally with serious congenital heart disease(CHD).Study desig n:A retrospective database review at 2 tertiary care fetal c...Objective:To determine outcome of delivery before 36 weeks gestation in babie s diagnosed antenatally with serious congenital heart disease(CHD).Study desig n:A retrospective database review at 2 tertiary care fetal cardiology centers.Details of neonatal course and outcome were obtained for those antenatally diagn osed with serious CHD who were live born before 36 weeks gestation.Results:Bet ween January 1998 and December 2002,9918 women were referred for fetal echocard iography.Serious CHD was diagnosed in 1191 fetuses(12%),of which 46(4%)de livered prematurely.Median gestation was 33(range 24-35)weeks,and median bi rth weight 1.56(0.50-3.59)kg.Extracardiac/karyotypic anomalies occurred in 23(50%).Twenty-six babies(57%)underwent neonatal surgery:16 a cardiac pr ocedure,5 a general surgical procedure,and 5 both.Eight died during or after operation(31%).Two babies underwent interventional heart catheterization;bot h died.The overall mortality rate was 72%.Extracardiac/karyotypic anomalies i ncreased the relative risk of death by a factor of 1.36.Mean hospital stay for those surviving to initial discharge was 46(2-137)days.Conclusions:There is a very high morbidity and mortality rate in this group,particularly for those with extracardiac/karyotypic anomalies.This should be reflected in decisions ov er elective preterm delivery and when counseling parents.展开更多
文摘Objective:To determine outcome of delivery before 36 weeks gestation in babie s diagnosed antenatally with serious congenital heart disease(CHD).Study desig n:A retrospective database review at 2 tertiary care fetal cardiology centers.Details of neonatal course and outcome were obtained for those antenatally diagn osed with serious CHD who were live born before 36 weeks gestation.Results:Bet ween January 1998 and December 2002,9918 women were referred for fetal echocard iography.Serious CHD was diagnosed in 1191 fetuses(12%),of which 46(4%)de livered prematurely.Median gestation was 33(range 24-35)weeks,and median bi rth weight 1.56(0.50-3.59)kg.Extracardiac/karyotypic anomalies occurred in 23(50%).Twenty-six babies(57%)underwent neonatal surgery:16 a cardiac pr ocedure,5 a general surgical procedure,and 5 both.Eight died during or after operation(31%).Two babies underwent interventional heart catheterization;bot h died.The overall mortality rate was 72%.Extracardiac/karyotypic anomalies i ncreased the relative risk of death by a factor of 1.36.Mean hospital stay for those surviving to initial discharge was 46(2-137)days.Conclusions:There is a very high morbidity and mortality rate in this group,particularly for those with extracardiac/karyotypic anomalies.This should be reflected in decisions ov er elective preterm delivery and when counseling parents.
