THỰC TRẠNG CHẨN ĐOÁN VÀ ĐIỀU TRỊ SỚM NHÓM TRẺ MẮC BỆNH TIM BẨM SINH NGUY KỊCH TẠI BỆNH VIỆN PHỤ SẢN TRUNG ƯƠNG GIAI ĐOẠN 2022-2024

Abstract

Objectives: To describe the current status of early diagnosis and treatment in neonates with critical congenital heart disease (CCHD) at the National Hospital of Obstetrics and Gynecology.

Subjects and Methods: A retrospective study was conducted on 28 neonates born at the National Hospital of Obstetrics and Gynecology, who were definitively diagnosed with CCHD during the period 2022–2024.

Results: The prenatal diagnosis rate was approximately 78.6%, indicating that the majority of cases were detected at 24–28 weeks of gestation. However, 21.4% of cases were not diagnosed prenatally and were only identified after the neonates exhibited clinical symptoms such as cyanosis or shock. The National Hospital of Obstetrics and Gynecology primarily implemented initial resuscitation measures including thermal regulation, stabilization of blood glucose, fluid therapy, and administration of initial antibiotic doses. Advanced treatment modalities, such as the use of Prostaglandin E1 (PGE1) and emergency cardiac surgery, were exclusively performed at the Vietnam National Children’s Hospital. The majority of neonates (60.7%) were transferred within the first 24 hours of life, with an average transfer age of 1.4 days. Although the transfer process was conducted promptly, only 75% of cases were transferred safely, indicating that risks remain during transport.

Conclusion: Critical congenital heart disease is a group of severe cardiac malformations that require early intervention, typically during the neonatal period or within the first year of life, to prevent circulatory collapse and mortality. The coordination between the National Hospital of Obstetrics and Gynecology and the Vietnam National Children’s Hospital contributes significantly to improving the effectiveness of initial treatment for neonates with CCHD.