Abstract

Aims: We evaluated the reasons of cardiac consultation and the rate of cardiovascular system (CVS) disease in neonates we followed at our NICU. Risk factors for congenital heart disease (CHD) and mortality rates were also investigated.Material-

Methods: During March 2005 – 2006 period, among 1146 neonates hospitalized at our NICU, we evaluated retrospectively the CVS findings of 119 neonates (Study group) examined by echocardiography.

Results: The most frequent (52.9%) reason for cardiology consultation was cardiac murmur. The incidences of CHD in all neonates and the study group were found as 3.49% and 33.6%, respectively. The most frequent acyanotic CHD and cyanotic CHD were patent ductus arteriosus and transposition of great arteries with a prevalence of 27.5% and 12.5%, respectively. Among 39 preterm newborns included in our study group, the incidence of symptomatic PDA was determined as 17.9%. The incidence of neonatal arrhythmia was found to be 1.6%. Supraventricular tachycardia and complet atrioventricular block were seen in 2 infants.Maternal diabetes mellitus and genetic syndromes (Down syndrome, Turner syndrome, Di-George syndrome, congenital rubella syndrome) were determined in 15 and 11 cases, respectively. Genetic syndromes and extracardiac abnormalities were the most common risk factors for CHD with ratios of 90.9% and 62.5%, respectively. Mortality rate of all neonates was 4.9% (57 cases) and 21% of them had CHD.

Conclusion: Patological heart murmur is the most important clinical findings for CHD in neonates. In this study, CVS disease were the most frequently observed in neonates associated with premature, genetic syndrome or extracardiac abnormalities and maternal diabetes mellitus. Among the mortality reasons of neonates, CHD still maintains its importance at our intensive care unit

Keywords: Cardiovascular Disease, Neonatal Intensive Care Unit, Echocardiography

References

  1. 1. Ainsworth S, Wylie JP, Wren C.Prevelance and clinical signifance of cardiac murmurs in neonates. Arch Dis Child Fetal and Neonatal Ed. 1999;
  2. 80: 43-45.
  3. 2. Meberg A, Lindberg H, Thaulow E.Congenital heart defects:the patients
  4. who die. Acta Pediatr. 2005;94:1060-1065.
  5. 3. Richmond S, Wren C. Early diagnosis of congenital heart disease. Semin
  6. Neonatal. 2001;6:27-35.
  7. 4. Rosati E, Chitano G, Dipaola L, De Felice C, Latini G. Indications and
  8. limitations for a neonatal pulse oximetry screening of critical congenitalheart disease. J Perinat Med. 2005; 33: 455-457.
  9. 5. Park MK, Troxler RG. Manifestation of cardiac disease problems in newborns. In: Park MK, Troxler RG (eds). Pediatric Cardiology.for practitioners. 4th ed. USA: Mosby Inc., 2002; 372-396.
  10. 6. Moss S, Kitchiner DJ, Yoxall CW, Subhedar NV. Evaluation of echocardiography on the neonatal unit. Arch Dis Child Fetal and Neonatal Ed.
  11. 2003;88: 287.
  12. 7. Azhar AS, Habib HS. Accuracy of initial evaluation of heart murmurs in
  13. neonates: Do we need an echocardiogram ?. Pediatr Cardiol. 2006;27:234-
  14. 237.
  15. 8. Du ZD, Roguin N, Barak M. Clinical and echocardiyografik evaluation of
  16. neonates with heart murrnurs. Acta Pediatr 1997;86:752-737.
  17. 9. Güven H, Bakiler AR, Kozan M, Aydınoglu H, Helvacı M, Dorak C.
  18. Echocardiographic screening in newborn infants. Çocuk Sağlığı ve
  19. Hastalıkları Dergisi 2006;49:8-11.
  20. 10. Aydoğdu SA, , Münevver Türkmen M, Özkan P. Adnan Menderes
  21. Ünıversitesi Yenidoğan yoğun bakım ünıtesinde izlenen bebeklerde doğumsal kalp hastalığı sıklığı ADÜ Tıp Fakültesi Dergisi 2008; 9:5-8.
  22. 11. Azaria JJT Rein, Samuel I Omokhodion, Amiram Nir. Signafance of a cardiac murmur as the sole clinical sign in the newborn. Clinical Pediatrics;
  23. 2000:511-520
  24. 12. Bernstein D. Epidemiology and genetic basis of congenital heart disease.
  25. In: Behrman RE, Kliegman RM, Jenson HB, (eds). Nelson Textbook of
  26. Pediatrics, 17th ed. Philadelphia : Saunders, 2004:1499-1502.
  27. 13. Samanek M. Congenital heart disease among 815.569 children born between 1980-1990 and their 15 year survival: Aprospective bohemia survival
  28. study. Pediatr Cardiol.1999;20:411-415.
  29. 14. Figueroa RJ, Magana PM, Hach P. Heart malformation in children with
  30. Down syndrome. Rev Esp Cardiol. 2003;56: 894-899
  31. 15. Atalay S, Balcı S, Özkutlu S, Erdal MD, Özme Ş. Yüz Down sendromlu
  32. vakada kongenital kalp hastalıklarının sıklığı ve ekokardiyografik değerlendirilmesi. Çocuk Sağlığı ve Hastalıkları Dergisi.1991;34:33-39.
  33. 16. Atalay S, Kürkçü F, Altuğ N, Dilek N, İmamoğlu A. Kromozom aberasyonları ile birlikte görülen konjenital kalp hastalıkları. MN Klinik Bilimler.
  34. 1996;11:186-190.
  35. 17. Kava MP, Tulu MS, Muranjan MN, Girisha KM. Down syndrome: clinical
  36. profile from India. Arch Med Res.2004;35:31-35.
  37. 18. Simsic JM, Coleman K, Maher KO, Cuadrado A, Kirshbom PM Do neonates with genetic abnormalities have an increased morbidity and mortality
  38. following cardiac surgery? Congenit Heart Dis. 2009;4:160-165.
  39. 19. Artman M, Mahony L, Teitel DF. Counseling families based on etiology
  40. and epidemiology. In Artman M. Mahony L, Teitel DF (eds). Neonatal
  41. Cardiology. 1th ed. USA: Mc Graw-Hill., 2002: 253-262.
  42. 20. Güçer Ş, İnceT, Kale G, Akçören Z, Özkutlu S. Noncardiac malformations
  43. in congenital heart disease; A retrospective analysis of 305 pediatric autopsies. The Turk J Pediatr. 2005; 47:159-166
  44. .
  45. 21. Abu-sulaiman RM, Subaih B. Congenital heart disease in infants of diabetic mothers: Echocardiographic study. Pediatr Cardiol 2004; 25: 137-140.
  46. 22. Ekici F, Atasay B, Günlemez A, Naçar N, Tutar E, Atalay S, Eyileten Z,
  47. Uysalel A, Arsan S. Management of patent ductus arteriosus in preterm
  48. infants. Anadolu Kardiyol Derg. 2006; 6: 28-33.
  49. 23. Gersony WM, Peckham GJ, Ellison RC, Miettinen OS, Nadas AS. Effects
  50. of indomethacin in premature infants with patent ductus arteriosus: results
  51. of a national collaborative study. J Pediatr. 1983;102: 895-906.
  52. 24. Artman M, Mahony L, Teitel DF. Common Arrhythmias. In Artman M.
  53. Mahony L, Teitel DF (eds). Neonatal Cardiology. 1th ed. USA: Mc GrawHill., 2002: 161-189.
  54. 25. Canpolat E, Korkmaz A, Yurdakök M, Çeliker A, Önderoğlu L, Özer S,
  55. Özkutlu S, Erdem G, Tekinalp G, Yiğit Ş. Neonatal aritmiler: yenidoğan
  56. yoğun bakım ünitesinde on yıllık deneyim. Çocuk Sağlığı ve Hastalıkları
  57. Dergisi.2003;46:187-194.

Copyright and license

How to cite

1.
Ekici F, Ünal S, Dablan S, Alpan N, Çevik BŞ, Vidinlisan S. CLINICAL AND ECHOCARDIOGRAPHIC EVALUATION OF 119 NEONATES IN NEONATAL INTENSIVE CARE UNIT. Turk J Pediatr Dis [Internet]. 2010 Dec. 1 [cited 2025 May 25];4(1):22-9. Available from: https://turkjpediatrdis.org/article/view/90