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    
Abstract/OtherAbstract:
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.
Authors:
Gregory R Samson; Suresh R Kumar
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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    
Affiliation:
Department of Neonatal Medicine, Al Corniche Hospital, Abu Dhabi, United Arab Emirates. Gregory@cornichehospital.au
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MeSH Terms
Descriptor/Qualifier:
Arrhythmias, Cardiac / ultrasonography
Female
Heart Defects, Congenital / ultrasonography*
Heart Murmurs
Heart Septal Defects, Ventricular / ultrasonography
Humans
Infant, Newborn
Neonatology*
Observer Variation
Pregnancy
Pregnancy in Diabetics
Reproducibility of Results
Comments/Corrections
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


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