Short Term Outcome of Children with Antenatally Diagnosed Heart Disease: A Retrospective Single Centre Study

Abstract

Introduction: The aim of foetal echocardiography is to improve the outcome of foetuses with congenital heart diseases. Impact of foetal echocardiography on the foetuses with antenatally diagnosed heart disease is less studied in public sector hospitals in India. Aim: To evaluate the short term outcome of infants born with antenatally diagnosed heart disease. Materials and Methods: This was a retrospective observational study conducted from April 2016 to June 2019 in a tertiary care public hospital in Northern India. Data was tabulated as mean, frequency and percentages, analysis were done in Microsoft excel 2013. Study included total of 1013 patients who underwent foetal echocardiography during the study period. Results: Heart disease was found in 59 patients after excluding five cases of ductal constriction. Referral for foetal echocardiography was frequently late. Among the group with abnormal foetal echocardiography, the mean gestational age at the time of diagnosis was 28.4 weeks. Follow-up data was available for 45 patients. A 24.4% (11/45) of those diagnosed with heart disease did not survive till term. 50% (17/34) of those born died before three months of age. Only two neonates underwent surgery before three months of age. Overall, 62.2% did not survive beyond three months of age. Conclusion: It was found that referrals for foetal echocardiography in setting were frequently late. Despite antenatal diagnosis the outcome for foetuses with heart disease was less than optimal. This reflects both the complexity of heart disease as well as lack of paediatric cardiac care to young infants in the setting. Access to high quality cardiac care for infants and neonates are essential for foetal echocardiography to have a meaningful impact on foetuses with heart disease.

Keywords

• echocardiography
• foetal
• neonates