CLINICAL AND PARACLINICAL CHARACTERISTICS OF CONGENITAL HEART DISEASE IN NEWBORN AT PEDIATRIC CENTER - HUE CENTRAL HOSPITAL

Van Chien Nguyen1, Hung Viet Phan2, Ngoc Minh Chau Nguyen3, Mai Linh Hoang3, Thi Thuy Linh Vu4
1 Tay Nguyen Regional General Hospital
2 Hue University of Medicine and Pharmacy
3 Hue Central Hospital
4 Tay Nguyen University

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Abstract

Objectives: Congenital heart disease (CHD) occurs in approximately 0,8% of live births. Early recognition of CHD is important for appropriate management and prognosis that need to study. The research results contribute to improving the quality of care, counseling and treatment of congenital heart disease in newborns.


Methods: Cross-sectional study analysis on 131 newborns with congenital heart disease admitted to Pediatric center – Hue Central Hospital from 05/2020-09/2022.


Results: Among 131 children with congenital heart disease (CHD), the male-to-female ratio was 1,5/1. Cyanotic CHD accounted for 59,6%, acyanotic CHD for 36,6%, and 3,8% L-TGA. The most common lesion was ventricular septal defect in the acyanotic group (13%) and Tetralogy of Fallot in the cyanotic group (13%). Critical CHD represented 45.8%, of which 85% were ductal-dependent critical CHD. Common clinical findings included Harzer’s sign (68.7%), tachypnea (64.6%), and heart murmur (56.3%) in the acyanotic group, whereas central cyanosis (100.0%), Harzer’s sign (93.6%), and abnormal S2 sound at the upper left sternal border (75.6%) predominated in the cyanotic group. Associated congenital anomalies were present in 22.9%. The overall mortality rate was 32.1%, higher in the cyanotic (38.5%) and severe CHD groups (56.7%), with the highest rates observed in hypoplastic left heart syndrome (100%), APSI (80%), and single ventricle (62.5%). Factors associated with severe CHD included cyanotic CHD (OR=8.0; 95% CI 2.2–29.1), heart failure complication (OR=6.0; 95% CI 1.8–20.0), and pre-post ductal SpO₂ difference ≥ 4% (OR=64.9; 95% CI 6.0–698.1)


Conclusion: The morbidity and mortality rate of critical congenital heart disease is high especially unless diagnosed early and managed appropriately. It is necessary to propagate the value of prenatal ultrasound and SpO2 in detecting congenital heart disease, to rational use of PGE1 in treatment CHD.

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References

1. Trần Thị Hạnh Chân. Nghiên cứu đặc điểm lâm sàng, cận lâm sàng bệnh tim bẩm sinh ở trẻ sơ sinh tại khoa Nhi - Bệnh viện Trung Ương Huế. Luận văn Thạc sỹ của Bác sĩ Nội Trú, Trường ĐH Y dược Huế, 2015.
2. Nguyễn Thị Thanh Hương, Vũ Minh Phúc. Đặc điểm bệnh lý tim bẩm sinh ở trẻ sơ sinh tại bệnh viện Nhi Đồng I. Tạp chí Y Học TP Hồ Chí Minh 2010;14(1):90-98.
3. Hồ Đăng Quân. Nghiên cứu mô hình dị tật bẩm sinh tại đơn vị sơ sinh Bệnh viện Trung Ương Huế. Luận văn thạc sĩ y học, Trường đại học Y Dược Huế, 2020.
4. Võ Phan Thảo Trang. Đặc điểm giải phẫu, lâm sàng, cận lâm sàng và điều trị tật tim bẩm sinh phụ thuộc ống đông mạch ở trẻ sơ sinh tại Bệnh viện Nhi Đồng 2. Luận văn chuyên khoa cấp II, Trường ĐH Y dược TP Hồ Chí Minh, 2020.
5. Võ Đức Trí, Cam Ngọc Phượng, Hà Mạnh Tuấn và cs. Đặc điểm lâm sàng và tỉ lệ tim bẩm sinh nặng ở trẻ sơ sinh mắc bệnh tim bẩm sinh tại bệnh viện Nhi Đồng 1 năm 2017 - 2018. Tạp chí Y Học TP Hồ Chí Minh 2019;23(4):120-125.
6. Phạm Nguyễn Vinh , Hoàng Trọng Kim , Nguyễn Lân Việt. Xử trí nội ngoại khoa bệnh tim bẩm sinh. Tạp chí Tim mạch học Việt Nam 2001;26:4-22.
7. Abou-Taleb A, Abdelhamid MA, Bahkeet AM. Clinical profile of cyanotic congenital heart disease in neonatal intensive care unit at Sohag University Hospital, Upper Egypt. Egyptian Journal of Medical Human Genetics 2017;18(1):47-51.
8. Centers for Disease Control and Prevention. Data and Statistics for Congenital Heart Disease. https://www.cdc.gov/ncbddd/heartdefects/data.html.
9. Dorfman AT, Marino BS, Wernovsky G et al. Critical heart disease in the neonate: presentation and outcome at a tertiary care center. Pediatr Crit Care Med 2008;9(2):193-202. https://doi.org/10.1097/pcc.0b013e318166eda5
10. Hoffman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol 2002;39(12):1890-1900. https://doi.org/10.1016/s0735-1097(02)01886-7
11. Kliegman RM, St Geme Joseph W, Blum NJ et al. Congenital Heart Disease. Nelson textbook of pediatrics, Elsevier 21th edition 2020:9335-9603
12. Krishna MR, Kumar RK. Diagnosis and Management of Critical Congenital Heart Diseases in the Newborn. Indian J Pediatr 2020;87(5):365-371. https://doi.org/10.1007/s12098-019-03163-4
13. Lee JY. Clinical presentations of critical cardiac defects in the newborn: Decision making and initial management. Korean J Pediatr 2010;53(6):669-679. https://doi.org/10.3345/kjp.2010.53.6.669
14. Mai CT, Isenburg JL, Canfield MA et al. National population-based estimates for major birth defects, 2010-2014. Birth Defects Res 2019;111(18):1420-1435. https://doi.org/10.1002/bdr2.1589
15. Mir A, Jan M, Ali I et al. Congenital heart disease in neonates: Their clinical profile, diagnosis, and their immediate outcome. Heart India 2019;7(2):80-84. http://dx.doi.org/10.4103/heartindia.heartindia_3_19
16. Mitchell SC, Korones SB, Berendes HW. Congenital heart disease in 56,109 births. Incidence and natural history. Circulation 1971;43(3):323-332. https://doi.org/10.1161/01.cir.43.3.323
17. Smith AH, Gay JC, Patel NR. Trends in resource utilization associated with the inpatient treatment of neonatal congenital heart disease. Congenit Heart Dis 2014;9(2):96-105. https://doi.org/10.1111/chd.12103