HAS ANTENATAL DIAGNOSIS OF TRANSPOSITION OF THE GREAT-ARTERIES CHANGED THE PROGNOSIS

Neonatal anatomical correction of transposition of the great arteries (TGA) has transformed the prognosis of this condition but the diagnosi s must be made rapidly. The aim of this retrospective study was to eva luate the benefits of antenatal diagnosis on the outcome of TGA. The c ases of SO consecutive neonates with TGA with or without ventricular s eptal defect hospitalised between 1989 and 1996 were reviewed. All the se children underwent anatomical correction of their malformation in t he neonatal period. In seventeen of the children the diagnosis was mad e in the antenatal period at a gestational age of 28.7 +/- 5 weeks of amenorrhea and the other 33 had a postnatal diagnosis at 6.2 +/- 13 da ys. The clinical and echographic features were identical in the two gr oups. The risk factors of mortality for the whole population were a Ya coub type B or C coronary disposition, an intramural coronary course, difficulties in reimplantation of the coronary arteries and/or peroper ative haemodynamic failure. In the authors' experience, the time of di agnosis (antenatal or postnatal) did not had on the management and pro gnosis of TGA. Studies with larger population groups are probably nece ssary to demonstrate the possible benefits of antenatal diagnosis.