EFFECT OF PRENATAL-DIAGNOSIS OF CRITICAL LEFT-HEART OBSTRUCTION ON PERINATAL MORBIDITY AND MORTALITY

We sought to determine the effect of prenatal diagnosis of congenital heart disease, specifically critical left heart obstructive (LHO) lesi ons, on postnatal morbidity and mortality. Several studies have found no significant improvement in mortality in infants with prenatally det ected heart disease compared to infants diagnosed postnatally. Few rep orts have focused on the specific effects of prenatal diagnosis on the perinatal course. All newborns with LHO seen between July 1993 and Ju ly 1996 were identified and divided into two groups based on prenatal vs. postnatal diagnosis. Hospital records were reviewed for demographi c and outcome variables. The outcome variables included degree of meta bolic acidosis, hemodynamic instability, noncardiac organ dysfunction, delayed surgical intervention, and surgical mortality. Twenty-three f etuses were diagnosed with LHO lesions. Postnatally, 45 newborns prese nted with LHO anomalies. Prenatal diagnosis resulted in avoidance of h emodynamic compromise, reduced organ dysfunction, and reduced surgical delays. There was no significant difference in surgical mortality. Pr enatal diagnosis significantly decreases postnatal morbidity in infant s with LHO lesions. Although surgical results are similar, the reduced morbidity decreases surgical delays and potentially may impact on neu rodevelopmental outcomes.