Document Detail

A study of congenital cardiac disease in a neonatal population--the validity of echocardiography undertaken by a neonatologist.
MedLine Citation:
PMID:  15679993     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To estimate the incidence of, and profile the spread of, congenital cardiac defects, and to assess the accuracy of the echocardiographic diagnosis as performed by a neonatologist. DESIGN: Hospital-based study. METHODS: All neonates meeting our criterions, specifically those with a persistent murmur 48 hours after birth, underwent an echocardiographic examination to exclude an underlying congenital cardiac defect. All scans performed by the neonatologist were videotaped and reviewed by a paediatric cardiologist. We assessed concordance according to inter-rater agreement. RESULTS: Out of 11,085 live births, there were 83 infants with a congenital cardiac defect, giving an incidence of 7.49 per 1000 live births, with 95% confidence interval from 5.88 to 9.09. Of the infants with a murmur persisting at or greater than 48 hours after birth, who had a median age of 4.5 days, 75% had a congenital heart defect, with ventricular septal defect being the commonest, encountered in 56.7% of cases. Concordance between the neonatologist and the cardiologist was good, with Cohen's Kappa coefficient being calculated at 0.68, and 95% confidence interval from 0.51 to 0.85. CONCLUSION: The incidence of congenital cardiac malformations as determined in our hospital-based study in the United Arab Emirates is similar to that described in the Gulf region and worldwide. A persistent murmur at or greater than 48 hours after birth is strongly suggestive of an underlying congenital cardiac malformation. Our experience shows that a neonatologist appropriately trained in echocardiography can perform as well as a paediatric cardiologist. Where specialist resources are limited, this allows for early diagnosis, earlier referral if necessary, and early institution of appropriate therapy.
Gregory R Samson; Suresh R Kumar
Related Documents :
6178163 - Deficiency of functional messenger rna for a developmentally regulated beta-crystallin ...
12239743 - Regional bias in birth defect prevalence rates for arkansas: influence of incomplete as...
9087903 - Breastfeeding patterns of low-birth-weight infants after hospital discharge.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cardiology in the young     Volume:  14     ISSN:  1047-9511     ISO Abbreviation:  Cardiol Young     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2005-01-31     Completed Date:  2005-06-09     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9200019     Medline TA:  Cardiol Young     Country:  England    
Other Details:
Languages:  eng     Pagination:  585-93     Citation Subset:  IM    
Department of Neonatal Medicine, Al Corniche Hospital, Abu Dhabi, United Arab Emirates.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Arrhythmias, Cardiac / ultrasonography
Heart Defects, Congenital / ultrasonography*
Heart Murmurs
Heart Septal Defects, Ventricular / ultrasonography
Infant, Newborn
Observer Variation
Pregnancy in Diabetics
Reproducibility of Results
Comment In:
Cardiol Young. 2006 Apr;16(2):198-9; author reply 197   [PMID:  16553989 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Use of small intestine submucosa as ureteral allograft in pigs.
Next Document:  Ventricular preexcitation associated with dilated cardiomyopathy: a causal relationship?