Obstetric and Neonatal Outcomes in Congenital Isolated Cardiac Anomalies - Single Center Experience

�a�l�yan, Erkan; Ozmen, Samican; Sar�da� Demir, S�reyya; Akd�ner, Asl�; Altunyurt, Sabahattin; Deliloglu, Burak; Y�ld�z, Kaan; Gen�, Halise Zeynep; K�r, Mustafa

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Obstetric and Neonatal Outcomes in Congenital Isolated Cardiac Anomalies - Single Center Experience [Forbes J Med]

Forbes J Med. 2020; 1(2): 42-50 | DOI: 10.5222/forbes.2020.39974

Obstetric and Neonatal Outcomes in Congenital Isolated Cardiac Anomalies - Single Center Experience

Erkan �a�l�yan¹, Samican Ozmen¹, S�reyya Sar�da� Demir¹, Asl� Akd�ner¹, Sabahattin Altunyurt¹, Burak Deliloglu², Kaan Y�ld�z³, Halise Zeynep Gen�³, Mustafa K�r³
¹Department of Obstetrics and Gynecology, Dokuz Eylul University, Izmir, Turkey
²Department of Neonatology,Dokuz Eylul University, Izmir, Turkey
³Department of Pediatric Cardiology,Dokuz Eylul University, Izmir, Turkey

INTRODUCTION: Evidence shows that rather than postnatal diagnoses, prenatal diagnoses of congenital heart diseases are correlated with better long-term results and lower mortality rates. In this retrospective study, neonatal stage results of infants with isolated cardiac anomalies, their indications for operation or intervention (if any), and the mortality rates in the first age are attempted to be demonstrated.
METHODS: The study was conducted through the retrospective analysis of 47 patients who were diagnosed with fetal cardiac anomaly in the antenatal period, and monitored during natal and postnatal stages at the same center in the Departments of Obstetrics and Gynecology and Pediatric Cardiology of Dokuz Eylul University Hospital.
RESULTS: In our center 36 patients gave birth by cesarean section, and 11 patients by spontaneous vaginal delivery. Two low birthweight neonates were born (<2500 g), and these neonates were observed to have hypoplastic left heart and Fallot tetralogy. Thirty-nine of the 47 neonates born with isolated cardiac anomaly were operated after birth. Five patients were advised follow-ups. The remaining 3 neonates died within 48 hours after birth. Survival rate of the operated neonates was 59.5% and the general survival rate was 59.5%. Average 1, and 5-minute APGAR scores of the infants were 7.8 (3-9) and 9.0 (8-10), respectively The neonates were operated an average of 3 days after birth, and the average duration hospitalization of neonates were 12 days. Twenty-nine neonates needed preoperative respiratory support and 37 of them received prostaglandin E1 infusion. Follow-up was advised for 3 neonates within the first month and the first year. Five neonates needed operation during the specified period, and 2 neonates died.
DISCUSSION AND CONCLUSION: In conclusion, prenatal diagnosis of congenital heart diseases allows planning the delivery in tertiary care centers, stabilization of the infants in the preoperative period and realization of emergency intervention.

Keywords: Congenital cardiac anomaly, postpartum cardiac operation, prenatal diagnosis

�zole Konjenital Kalp Hastal�lar�nda Obstetrik ve Neonatal Sonu�lar - Tek Merkez Deneyimi

Erkan �a�l�yan¹, Samican Ozmen¹, S�reyya Sar�da� Demir¹, Asl� Akd�ner¹, Sabahattin Altunyurt¹, Burak Deliloglu², Kaan Y�ld�z³, Halise Zeynep Gen�³, Mustafa K�r³
¹Dokuz Eyl�l �niversitesi T�p Fak�ltesi, Kad�n Hastal�klar� ve Do�um Anabilim Dal�, �zmir
²Dokuz Eyl�l �niversitesi T�p Fak�ltesi, Neonatoloji Bilim Dal�,�zmir
³Dokuz Eyl�l �niversitesi T�p Fak�ltesi, �ocuk Kardiyolojisi Bilim Dal�

G�R�� ve AMA�: Konjenital kalp hastal�klar�n�n prenatal tan�s�n�n, postnatal tan�ya g�re daha iyi uzun d�nem sonu�lar ve daha az mortalite oranlar�yla ili�kisi oldu�uyla ilgili kan�tlar vard�r. Bu �al��mada, izole kardiak anomalisi olan infantlar�n, neonatal d�nem sonu�lar�, operasyon veya giri�im gereksinimi olup olmad�klar� ve ilk 1 ya� i�erisindeki mortalite sonu�lar� retrospektif olarak g�sterilmeye �al��lm��t�r.
Y�NTEM ve GERE�LER: Bu �al��ma, Nisan 2013 ile Aral�k 2019 tarihleri aras�nda, Dokuz Eyl�l �niversitesi Hastanesi Kad�n Hastal�klar� ve Do�um Anabilim Dal� ve Pediatrik Kardiyoloji Anabilim Dal�nda, antenatal d�nemde izole fetal kardiyak anomali tan�s� alan, do�umu ve do�um sonras� izlemi ayn� merkezde ger�ekle�en 47 hastan�n, kay�tlar�n�n retrospektif incelenmesi ile yap�lm��t�r.
BULGULAR: Merkezimizde do�um yapan hastalar�n, 36�s� sezaryenle, 11�i vajinal yolla do�umunu ger�ekle�tirmi�tir. �ki bebek d��k do�um a��rl��yla d�nyaya gelmi�tir (<2500 g). Bu bebeklerde hipoplastik sol kalp ve fallot tetralojisi izlenmi�tir. �zole kardiyak anomali ile do�an 47 yenido�an�n, 39�u do�um sonras� opere edilmi�tir. Be� hastaya takip �nerilmi�tir. Geri kalan 3 bebek postpartum ilk 48 saat i�erisinde ex olmu�tur. Opere olan bebeklerde sa� kal�m %59,5, genel sa� kal�m %59,5�tir. �nfantlar�n 1. dk. APGAR skoru ortalamas� 7,8 (3-9); 5. dk. APGAR skoru ortalamas� 9,0 (8-10)�d�r. Ortalama operasyon g�n�, postpartum 3. g�n, ortalama yenido�an yat�� s�resi 12 g�nd�r. 29 bebe�in preoperatif solunum deste�i gereksinimi olmu�, 37 bebek prostaglandin E1 inf�zyonu alm��t�r. Bir ay-1 ya� aras� d�nemde 3 bebe�e takip �nerilmi�, 5 bebe�in bu d�nemde operasyon gereksinimi olmu� ve 2 bebek bu d�nemde ex olmu�tur.
TARTI�MA ve SONU�: Konjenital kalp hastal�klar�n�n prenatal olarak tan�nmas�, do�umun ��nc� basamak merkezlerde planlanmas�, infantlar�n, preoperatif d�nemde stabil hale getirilmesi ve acil m�dahalelerin yap�labilmesine olanak sa�lamaktad�r.

Anahtar Kelimeler: Konjenital kardiyak anomali, postpartum kardiyak operasyon, prenatal tan�

Corresponding Author: Erkan �a�l�yan, T�rkiye
Manuscript Language: Turkish

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