ECHOCARDIOGRAPHIC SCREENING IN NEONATES UNDERGOING SURGERY FOR SELECTED GASTROINTESTINAL MALFORMATIONS

To compare echocardiography with clinical examination, radiography, an d electrocardiography for the detection of congenital heart defects (C HD) a four year prospective study was carried out in 166 neonates with selected congenital gastrointestinal malformations (anorectal anomaly , tracheo-oesophageal fistula, duodenal atresia, exomphalos, and gastr oschisis). Routine examination and investigation detected CHD in 16 ne onates. Using echocardiography CHD was diagnosed in 38 (23%) neonates of whom five had two gastrointestinal malformations: in 22/57 (39%) wi th a tracheo-oesophageal fistula, 10/67 (15%) with an anorectal anomal y, 4/20 (20%) with exomphalos, 6/20 (30%) with duodenal atresia, and 1 /7 with gastroschisis. A significantly higher incidence of CHD in neon ates with gastrointestinal malformations was diagnosed using echocardi ography (23%) compared with routine examination and investigation (9%) . Early diagnosis of CHD allowed a unified approach to be presented to the family.