Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1
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Index Copernicus  – 161.11; MEiN – 140 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2019, vol. 28, nr 12, December, p. 1691–1695

doi: 10.17219/acem/110327

Publication type: original article

Language: English

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Echocardiographic ultrasound screening assessment of the circulatory system of newborns delivered at basic level perinatal care centers

Joanna Kukawczynska-Noczynska1,A,C,D, Rita Suchanska2,B, Marta Berghausen-Mazur2,B,E

1 1st Department and Clinic of Pediatrics, Allergology and Cardiology, Wroclaw Medical University, Poland

2 1st Department and Clinic of Gynaecology and Obstetrics, Wroclaw Medical University, Poland

Abstract

Background. For many years standards of medical care for newborns have been created and perfected with the goal of improving care, including early detection of congenital defects.
Objectives. The objective of the study was to assess the circulatory system in newborns born at basic level of perinatal care centers and the comparison of specific parameters of cardiac function and structure according to the method of birth, body mass, sex, Apgar score, pulse oximetry results, and presence of other pathologies.
Material and Methods. The study was carried out in 255 newborns aged 3–14 days. The children were assessed according to Apgar score, were weighed and pulse oximetry testing was carried out, and symptoms of neonatal jaundice or infection were taken into account. Each child was subjected to a physical examination and echocardiographic examination.
Results. Among the group studied, 3.5% of children had defects of the circulatory system and functional disorders.
Conclusion. Pulse oximetry testing, due to its low level of invasiveness, high sensitivity and specificity, low cost and repeatability, should be used as the primary screening test, allowing for early detection of critical congenital heart defects (CHDs). It should be stressed that the test should be repeated before discharge of newborns from the neonatology department so as to avoid missing CHDs which are asymptomatic or mute at birth. Morphological and functional assessment of specific structures of the heart in delivered newborns showed correlation of the size of the left ventricle (LV) with body mass. The remaining factors, such as method of delivery, sex, neonatal jaundice, and audible murmur, were irrelevant. Routine cardiological assessment of healthy newborns is therefore not necessary.

Key words

congenital heart defect, echocardiography, newborn

References (25)

  1. Ministerstwo Zdrowia. Program polityki zdrowotnej. Program badań przesiewowych noworodków w Polsce na lata 2015–2018. Warszawa, Poland: Ministerstwo Zdrowia; 2017.
  2. Stanek B, Binikowska J, Moll J, Sysa A. Wrodzone nieprawidłowości układu krążenia u noworodków urodzonych w Instytucie Zdrowia Matki Polki w Łodzi w latach 1998–2004. Post Neonatol. 2004;Suppl 2:14–17.
  3. Kirshnamurthy G, Ratner V, Levasseur S, Rubenstein D. Wrodzone wady serca w okresie noworodkowym. Neonatologia w praktyce. Warszawa, Poland: MediPage; 2015:256.
  4. Peterson C, Grosse SD, Glidewell J, et al. A public health economic assessment of hospitals’ cost to screen newborns for critical congenital heart disease. Public Health Rep. 2014;129(1):86–93.
  5. Gadzinowski J, Gruszfeld D, Czech-Kowalska J. Organizacja opieki nad noworodkiem w skali regionalnej. Standardy opieki medycznej nad noworodkiem w Polsce. Zalecenia Polskiego Towarzystwa Neonato­logicznego. 2nd ed. Warszawa, Poland: Media-Press; 2017:12–16.
  6. Brand A, Alves MC, Saraiva CL. Fetus in fetu: Diagnostic criteria and differential diagnosis. A case report and literature review. J Pediatr Surg. 2004;39(4):616–618.
  7. Mroziński B, Siwińska A, Sobkowski W, Maciejewski J. Wrodzone wady układu krążenia u noworodków i niemowląt diagnozowanych w pracowni echokardiograficznej Kliniki Chorób Dzieci Instytutu Pediatrii Akademii Medycznej im. Karola Marcinkowskiego w Poznaniu w latach 1995–1999. Post Neonatol. 2000;Suppl 1;119–123.
  8. Rozporządzenie Ministra Zdrowia z dnia 20 września 2012 r. (Dz. U. z dnia 4.10.2012 r. Nr 189, poz. 1100).
  9. Thangaratinam S, Brown K, Zamora J, Khan KS, Ewer AK. Pulse oximetry screening for critical congenital heart defects in asymptomatic newborn babies: A systematic review and meta-analysis. Lancet. 2012;379(9835):245–264.
  10. Kawalec W, Turska-Kmieć A, Żuk M, et al. Poprawa opieki kardiologicznej nad dzieckiem z patologią układu krążenia ze szczególnym uwzględnieniem oceny wyników leczenia i lepszej jakości życia dzieci z wrodzonymi wadami serca. Ogólnopolski program wielozadaniowy i wieloośrodkowy realizowany w ramach programu POLKARD 2006–2008. Stand Med Pediatr. 2009;6:614–622.
  11. Błaż W, Turska–Kmieć A. Pulsoksymetria jako metoda wykrywania wad wrodzonych serca u bezobjawowych noworodków. Pediatr Dypl. 2010;14(4):107–112.
  12. Fukazawa M, Fukushige J, Veda K. Atrial septal defect in neonates with references to spontaneous closure. Am Heart J. 1988;116(1 Pt 1):123–127.
  13. Sachdeva R. Congenital cardiovascular malformations; Atrial septal defects. In: Allen HD, Driscoll DJ, Shaddy RE, Feltes TF, eds. Moss and Adams’ Heart Disease in Infants, Children, and Adolescents: Including the Fetus and Young Adult. Vol 1. 8th ed, Philadelphia, PA; Lippincott Williams & Wilkins. 2013:683–688.
  14. Soto B, Becker AE, Moulaert AJ, Lie JT, Anderson RH. Classification of ventricular septal defects. Br Heart J. 1980;43(3):332–343.
  15. Kubicka K, Kawalec W, Bernatowska E. Pediatria. Warszawa, Poland: Wydawnictwo Lekarskie PZWL; 2004:311–317.
  16. Andreson RH, Macartney FJ, Shinebourne EA, et al. Paediatric Cardio­logy. 2nd ed. London, UK: Churchill Livingstone; 2002:278–284.
  17. Biamino G, Lange L. Echokardiographie- Stellenwert in der kardiologischen Diagnostik. Frankfurt am Main, Germany: Hoechst Verlag; 1983:134–138.
  18. Cantinotti M, Scalese M, Murzi B, Murzi B, Passino C. Echocardiographic nomograms for chamber diameters and areas in Caucasian children. J Am Soc Echocardiogr. 2014;27(12):1279–1292.e2.
  19. Cantinotti M, Scalese M, Molinaro S, Murzi B, Passino C. Limitations of current echocardiographic nomograms for left ventricular, valvular, and arterial dimensions in children: A critical review. J Am Soc Echocardiogr. 2012;25(2):142–152.
  20. Siwińska A, Werner B, Rudziński A, et al; Echocardiography Working Group of the Polish Cardiology Society. Paediatric echocardiography in clinical practice. 2012 Recommendations of the Echocardiography Working Group of the Polish Cardiac Society [in Polish]. Kardiol Pol. 2012;70(6):632–640.
  21. Kampmann C, Wiethoff CM, Wenzel A, et al. Normal values of M mode echocardiographic measurements of more than 2000 healthy infants and children in central Europe. Heart. 2000;83(6):667–672.
  22. Lopez L, Colan SD, Frommelt PC, et al. Recommendations for quantification methods during the performance of a pediatric echocardiogram: A report from the Pediatric Measurements Writing Group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council. J Am Soc Echocardiogr. 2010;23(5):465–95
  23. Mawad W, Drolet C, Dahdah N, Dallaire F. A review and critique of the statistical methods used to generate reference values in pediatric echocardiography. J Am Soc Echocardiogr. 2013;26(1):29–37.
  24. Colan SD. The why and how of Z-scores. J Am Soc Echocardiogr. 2013;26(1):38–40.
  25. Gokhroo RK, Anantharaj A, Bisht D, Kishor K, Plakkal N, Mondal N. A pediatric echocardiographic Z-score nomogram for a developing country. Indian pediatric echocardiography study: The Z-score. Ann Pediatr Cardiol. 2017;11(1):109–111.
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