PERINATOLOGIYA I PEDIATRIYA.2013.3(55):85–88

Results and problems of management of newborns with congenital heart diseases

Klimenko T. M., Sorokolat Yu. V., Karapetyan O. Yu.

Kharkiv Medical Academy of Postgraduate Education

Health Care Department of Kharkiv City Council

Objective. To investigate the factors that determines the frequency and structure of congenital heart disease (CHD) in newborns for identification of the problem of its prenatal diagnosis, treatment and reserves of improvement of the quality of administration in conditions of Perinatal Center.

Patients and methods. Among 817 newborns with CHD who were treated at the Kharkiv City Perinatal Center (KCPC) in 2007–2012 y. have been conducted clinical and laboratory monitoring of children's health: heart rate, respiration, pulse characteristics and blood pressure in all extremities, state of parenchymal organs; ultrasound with doppler, electrocardiogram (ECG); chest X-ray; in case of detection of arrhythmia – Holter ECG monitoring. All children were counseled by children cardiorheumatologist, neurologist, geneticist, according to the indication — by heart surgeon.

Results. It is found that for the period 2007-2012 y. A total number of CHD in absolute terms increased in 1.8 times (from 93 to 167 cases per year) and the number of patients treated in hospital — in 1.6 times (from 4.2% to 6.8%). The exception was 2012 y., when KCPC for 1.5 months was closed for repairs. For the last 3 years the number of newborns with congenital heart diseases from the number of patients treated in the hospital was stable. In the structure prevailed isolated CHD and their share increased from 65% to 85 %. This is associated with improving the quality of diagnosis, including hemodynamically significant patent ductus arteriosus (PDA), in preterm infants from 2009 year.

Conclusions. Reserves of disability and death reduction from CHD in children is an improvement and timeliness of prenatal diagnosis for the possibility of termination of pregnancy in case of fetal combined CHD, radical correction of which cannot be done, especially in combination with syndromic or chromosomal abnormality. It is important to identify the reasons for the formation of the CHP in each case and the desirability of maintenance of pregnancy. To ensure quality management of newborns with CHD in the congenital neonatal hospitals should be establish and implement standards of medical care and intensive therapy in the neonatal period.

Key words: newborn, congenital heart disease.

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