Detection of cardiovascular abnormalities in the nursery of a general hospital in the Amazon region: correlation with potential risk factors

Congenital heart diseases have been studied much more extensively in childr en than in neonates. In this study, we report on the findings from 57 neona tes seen from June of 1995 through June 1996 in the nursery of a large publ ic hospital in Belem, Para, Brazil. All were routinely examined by a paedia trician just after birth, and, when indicated, these babies were referred t o the cardiology unit of our Hospital for assessment by a paediatric cardio logist. Most of the diagnoses were made by means of Doppler and cross-secti onal echocardiography with color flow mapping. Several abnormalities of the cardiovascular system were diagnosed. The most frequent was patency of the arterial duct. But, since many ducts closed spontaneously, ventricular sep tal defect was the most frequent lesion seen even in the nursery. Four defe cts (patent arterial duct, ventricular septal defect,;atrial septal defect and pulmonary stenosis) together accounted for two thirds of all cardiac ab normalities. Associated non-cardiac anomalies were more frequent in those w ith simple lesions within the heart. All the babies with complex heart dise ase, and the majority of those designated as having significant lesions, di ed before they could be discharged. Several risk factors were investigated. Among maternal drugs, misoprostol emerged as having a possible teratogenic effect.