Detection of transposition of the great arteries in fetuses reduces neonatal morbidity and mortality
Transposition of the great arteries (TGA) is a life-threatening malformation in neonates, but it is amenable to complete repair. Prenatal detection, diagnosis, and early management may modify neonatal mortality and mortality. Preoperative and postoperative morbidity and mortality were compared in 68...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 1999-02, Vol.99 (7), p.916-918 |
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| container_title | Circulation (New York, N.Y.) |
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| creator | BONNET, D COLTRI, A BUTERA, G FERMONT, L LE BIDOIS, J KACHANER, J SIDI, D |
| description | Transposition of the great arteries (TGA) is a life-threatening malformation in neonates, but it is amenable to complete repair. Prenatal detection, diagnosis, and early management may modify neonatal mortality and mortality.
Preoperative and postoperative morbidity and mortality were compared in 68 neonates with prenatal diagnosis and in 250 neonates with a postnatal diagnosis of TGA over a period of 10 years. The delay between birth and admission was 2+/-2.8 hours in the prenatal group and 73+/-210 hours in the neonatal group (P |
| doi_str_mv | 10.1161/01.cir.99.7.916 |
| format | Article |
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Preoperative and postoperative morbidity and mortality were compared in 68 neonates with prenatal diagnosis and in 250 neonates with a postnatal diagnosis of TGA over a period of 10 years. The delay between birth and admission was 2+/-2.8 hours in the prenatal group and 73+/-210 hours in the neonatal group (P<0.01). Clinical condition at arrival, including metabolic acidosis and multiorgan failure, was worse in the neonatal group (P<0.01). Once in the pediatric cardiology unit, the management was identical in the 2 groups (atrioseptostomy, PGE1 infusion, operation date). Preoperative mortality was 15 of 250 (6%; 95% CI, 3% to 9%) in the neonatal group and 0 of 68 in the prenatal group (P<0.05). Postoperative morbidity was not different (25 of 235 versus 6 of 68), but hospital stay was longer in the neonatal group (30+/-17 versus 24+/-11 days, P<0.01). In addition, postoperative mortality was significantly higher in the neonatal group (20 of 235 versus 0 of 68, P<0.01); however, the known risk factors for operative mortality were identical in the 2 groups.
Prenatal diagnosis reduces mortality and morbidity in TGA. Prenatal detection of this cardiac defect must be increased to improve early neonatal management. In utero transfer of fetuses with prenatal diagnosis of TGA in an appropriate unit is mandatory.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/01.cir.99.7.916</identifier><identifier>PMID: 10027815</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Biological and medical sciences ; Cardiology. Vascular system ; Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava ; Heart ; Humans ; Infant Mortality ; Infant, Newborn ; Medical sciences ; Morbidity ; Postoperative Complications - mortality ; Transposition of Great Vessels - diagnosis ; Transposition of Great Vessels - diagnostic imaging ; Transposition of Great Vessels - surgery ; Ultrasonography, Prenatal</subject><ispartof>Circulation (New York, N.Y.), 1999-02, Vol.99 (7), p.916-918</ispartof><rights>1999 INIST-CNRS</rights><rights>Copyright American Heart Association, Inc. Feb 23, 1999</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c542t-5e0dd09bcd91bb813c94aca4cbcd4487da36531e0d2cea1e03bd9844651355c03</citedby><cites>FETCH-LOGICAL-c542t-5e0dd09bcd91bb813c94aca4cbcd4487da36531e0d2cea1e03bd9844651355c03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3673,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1694788$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10027815$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>BONNET, D</creatorcontrib><creatorcontrib>COLTRI, A</creatorcontrib><creatorcontrib>BUTERA, G</creatorcontrib><creatorcontrib>FERMONT, L</creatorcontrib><creatorcontrib>LE BIDOIS, J</creatorcontrib><creatorcontrib>KACHANER, J</creatorcontrib><creatorcontrib>SIDI, D</creatorcontrib><title>Detection of transposition of the great arteries in fetuses reduces neonatal morbidity and mortality</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>Transposition of the great arteries (TGA) is a life-threatening malformation in neonates, but it is amenable to complete repair. Prenatal detection, diagnosis, and early management may modify neonatal mortality and mortality.
Preoperative and postoperative morbidity and mortality were compared in 68 neonates with prenatal diagnosis and in 250 neonates with a postnatal diagnosis of TGA over a period of 10 years. The delay between birth and admission was 2+/-2.8 hours in the prenatal group and 73+/-210 hours in the neonatal group (P<0.01). Clinical condition at arrival, including metabolic acidosis and multiorgan failure, was worse in the neonatal group (P<0.01). Once in the pediatric cardiology unit, the management was identical in the 2 groups (atrioseptostomy, PGE1 infusion, operation date). Preoperative mortality was 15 of 250 (6%; 95% CI, 3% to 9%) in the neonatal group and 0 of 68 in the prenatal group (P<0.05). Postoperative morbidity was not different (25 of 235 versus 6 of 68), but hospital stay was longer in the neonatal group (30+/-17 versus 24+/-11 days, P<0.01). In addition, postoperative mortality was significantly higher in the neonatal group (20 of 235 versus 0 of 68, P<0.01); however, the known risk factors for operative mortality were identical in the 2 groups.
Prenatal diagnosis reduces mortality and morbidity in TGA. Prenatal detection of this cardiac defect must be increased to improve early neonatal management. In utero transfer of fetuses with prenatal diagnosis of TGA in an appropriate unit is mandatory.</description><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava</subject><subject>Heart</subject><subject>Humans</subject><subject>Infant Mortality</subject><subject>Infant, Newborn</subject><subject>Medical sciences</subject><subject>Morbidity</subject><subject>Postoperative Complications - mortality</subject><subject>Transposition of Great Vessels - diagnosis</subject><subject>Transposition of Great Vessels - diagnostic imaging</subject><subject>Transposition of Great Vessels - surgery</subject><subject>Ultrasonography, Prenatal</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkEtLxDAUhYMoOj7W7qSIuGvNzaNpljK-BgYE0XVIk1QjnXZM0oX_3sgMKq7OPYfvXi4HoVPAFUANVxgq40MlZSUqCfUOmgEnrGScyl00wxjLUlBCDtBhjO_Z1lTwfXQAGBPRAJ8he-OSM8mPQzF2RQp6iOsx-p_gzRWvwelU6JBc8C4Wfig6l6aYx-DsZLIObhx00n2xGkPrrU-fhR7st8thdsdor9N9dCdbPUIvd7fP84dy-Xi_mF8vS8MZSSV32FosW2MltG0D1EimjWYmJ4w1wmpacwqZIsbprLS1smGs5kA5N5geocvN3XUYPyYXk1r5aFzf6_zhFFUtecMJsAye_wPfxykM-TdFgAgmieAZutpAJowxBtepdfArHT4VYPXdvsKg5osnJaUSKrefN862Z6d25ewfflN3Bi62gI5G912u2_j4y9WSiaahXwOvjmY</recordid><startdate>19990223</startdate><enddate>19990223</enddate><creator>BONNET, D</creator><creator>COLTRI, A</creator><creator>BUTERA, G</creator><creator>FERMONT, L</creator><creator>LE BIDOIS, J</creator><creator>KACHANER, J</creator><creator>SIDI, D</creator><general>Lippincott Williams & Wilkins</general><general>American Heart Association, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>19990223</creationdate><title>Detection of transposition of the great arteries in fetuses reduces neonatal morbidity and mortality</title><author>BONNET, D ; COLTRI, A ; BUTERA, G ; FERMONT, L ; LE BIDOIS, J ; KACHANER, J ; SIDI, D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c542t-5e0dd09bcd91bb813c94aca4cbcd4487da36531e0d2cea1e03bd9844651355c03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava</topic><topic>Heart</topic><topic>Humans</topic><topic>Infant Mortality</topic><topic>Infant, Newborn</topic><topic>Medical sciences</topic><topic>Morbidity</topic><topic>Postoperative Complications - mortality</topic><topic>Transposition of Great Vessels - diagnosis</topic><topic>Transposition of Great Vessels - diagnostic imaging</topic><topic>Transposition of Great Vessels - surgery</topic><topic>Ultrasonography, Prenatal</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>BONNET, D</creatorcontrib><creatorcontrib>COLTRI, A</creatorcontrib><creatorcontrib>BUTERA, G</creatorcontrib><creatorcontrib>FERMONT, L</creatorcontrib><creatorcontrib>LE BIDOIS, J</creatorcontrib><creatorcontrib>KACHANER, J</creatorcontrib><creatorcontrib>SIDI, D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>BONNET, D</au><au>COLTRI, A</au><au>BUTERA, G</au><au>FERMONT, L</au><au>LE BIDOIS, J</au><au>KACHANER, J</au><au>SIDI, D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Detection of transposition of the great arteries in fetuses reduces neonatal morbidity and mortality</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>1999-02-23</date><risdate>1999</risdate><volume>99</volume><issue>7</issue><spage>916</spage><epage>918</epage><pages>916-918</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>Transposition of the great arteries (TGA) is a life-threatening malformation in neonates, but it is amenable to complete repair. Prenatal detection, diagnosis, and early management may modify neonatal mortality and mortality.
Preoperative and postoperative morbidity and mortality were compared in 68 neonates with prenatal diagnosis and in 250 neonates with a postnatal diagnosis of TGA over a period of 10 years. The delay between birth and admission was 2+/-2.8 hours in the prenatal group and 73+/-210 hours in the neonatal group (P<0.01). Clinical condition at arrival, including metabolic acidosis and multiorgan failure, was worse in the neonatal group (P<0.01). Once in the pediatric cardiology unit, the management was identical in the 2 groups (atrioseptostomy, PGE1 infusion, operation date). Preoperative mortality was 15 of 250 (6%; 95% CI, 3% to 9%) in the neonatal group and 0 of 68 in the prenatal group (P<0.05). Postoperative morbidity was not different (25 of 235 versus 6 of 68), but hospital stay was longer in the neonatal group (30+/-17 versus 24+/-11 days, P<0.01). In addition, postoperative mortality was significantly higher in the neonatal group (20 of 235 versus 0 of 68, P<0.01); however, the known risk factors for operative mortality were identical in the 2 groups.
Prenatal diagnosis reduces mortality and morbidity in TGA. Prenatal detection of this cardiac defect must be increased to improve early neonatal management. In utero transfer of fetuses with prenatal diagnosis of TGA in an appropriate unit is mandatory.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>10027815</pmid><doi>10.1161/01.cir.99.7.916</doi><tpages>3</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Circulation (New York, N.Y.), 1999-02, Vol.99 (7), p.916-918 |
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| source | MEDLINE; American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Journals@Ovid Complete |
| subjects | Biological and medical sciences Cardiology. Vascular system Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava Heart Humans Infant Mortality Infant, Newborn Medical sciences Morbidity Postoperative Complications - mortality Transposition of Great Vessels - diagnosis Transposition of Great Vessels - diagnostic imaging Transposition of Great Vessels - surgery Ultrasonography, Prenatal |
| title | Detection of transposition of the great arteries in fetuses reduces neonatal morbidity and mortality |
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