Universal Screening for Extracardiac Abnormalities in Neonates with Congenital Heart Disease

被引:0
作者
Javier H. Gonzalez
Girish S. Shirali
Andrew M. Atz
Sarah N. Taylor
Geoffrey A. Forbus
Sinai C. Zyblewski
Anthony M. Hlavacek
机构
[1] Medical University of South Carolina,Department of Pediatrics, Cardiology
[2] Medical University of South Carolina,Department of Pediatrics, Neonatology
来源
Pediatric Cardiology | 2009年 / 30卷
关键词
Congenital heart disease; Extracardiac; Screening;
D O I
暂无
中图分类号
学科分类号
摘要
Extracardiac or genetic abnormalities (EGA) represent a factor in the morbidity of patients with congenital heart disease. We evaluated the way neonates with CHD are screened at our institution and determined the yield for the screening tests. We reviewed the charts of 223 neonates with structural CHD. Subjects were categorized into 6 groups: univentricular, left-sided obstructive lesions, right-sided obstructive lesions, septal defects, conotruncal defects (CTD), and other. We reviewed which patients underwent cranial ultrasonogram (CUS), abdominal ultrasonogram (AUS), and/or genetic studies (GS) as well as their results. There was a high prevalence of EGA in each group by CUS (32% to 42%), AUS (32% to 69%), and GS (10% to 60%). There was considerable variability in the proportion within each group that underwent screening tests, and the consistency of screening often was not congruent with the likelihood of abnormal results. Approximately 50% of our patients had ≥1 EGA identified, resulting in a cost-yield ratio of $4,508/patient with EGA. Screening for EGA at our institution is not uniform and is often at odds with the prevalence of such patients. Given the high prevalence of EGA, we advocate for a universal screening program for neonates with CHD using cranial/abdominal ultrasonography and genetic testing.
引用
收藏
页码:269 / 273
页数:4
相关论文
共 50 条
  • [1] Allan LD(1992)Prognosis in fetal tetralogy of Fallot Pediatr Cardiol 13 1-4
  • [2] Sharland GK(2006)Outcome of fetal cardiac defects Curr Opin Pediatr 18 490-496
  • [3] Cuneo BF(2005)Prevalence of hyperechoic renal pyramid syndrome in neonates and infants with congenital heart disease―Ultrasound study of the abdominal cavity in the years 1996–2000 Wiad Lek 58 7-10
  • [4] Czarniak P(2006)Prevalence of congenital kidney and urinary tract anomalies in neonates and infants with congenital heart disease Przegl Lek 63 124-126
  • [5] Kosiak W(1990)Congenital brain anomalies associated with the hypoplastic left heart syndrome Pediatrics 85 984-990
  • [6] Chojnicki M(1984)Cardiovascular malformations associated with extracardiac anomalies and malformation syndromes. Patterns for diagnosis Clin Pediatr 23 145-151
  • [7] Czarniak P(1976)Cardiovascular malformations associated with congenital anomalies of the urinary system. Observations in a series of 453 infants and children with urinary system malformations Clin Pediatr 15 1101-1104
  • [8] Kosiak W(1978)Frequency of association of cardiac and urinary abnormalities Sem Hop 54 437-441
  • [9] Chojnicki M(2001)Diagnosis, natural history, and outcome of fetal heart disease Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 4 229-243
  • [10] Glauser TA(2007)Congenital heart defects—Chromosomal anomalies, syndromes and extracardiac malformations Acta Paediatr 96 1142-1145