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Objective:To determine outcome of delivery before 36 weeks gestation in babie s diagnosed antenatally with serious congenital heart disease(CHD).Study desig n:A retrospective database review at 2 tertiary care fetal cardiology centers.Details of neonatal course and outcome were obtained for those antenatally diagn osed with serious CHD who were live born before 36 weeks gestation.Results:Bet ween January 1998 and December 2002,9918 women were referred for fetal echocard iography.Serious CHD was diagnosed in 1191 fetuses(12%),of which 46(4%)de livered prematurely.Median gestation was 33(range 24-35)weeks,and median bi rth weight 1.56(0.50-3.59)kg.Extracardiac/karyotypic anomalies occurred in 23(50%).Twenty-six babies(57%)underwent neonatal surgery:16 a cardiac pr ocedure,5 a general surgical procedure,and 5 both.Eight died during or after operation(31%).Two babies underwent interventional heart catheterization;bot h died.The overall mortality rate was 72%.Extracardiac/karyotypic anomalies i ncreased the relative risk of death by a factor of 1.36.Mean hospital stay for those surviving to initial discharge was 46(2-137)days.Conclusions:There is a very high morbidity and mortality rate in this group,particularly for those with extracardiac/karyotypic anomalies.This should be reflected in decisions ov er elective preterm delivery and when counseling parents.
Objective: To determine outcome of delivery before 36 weeks gestation in babie s diagnosed antenatally with serious congenital heart disease (CHD). Study desig n: A retrospective database review at 2 tertiary care fetal cardiology centers. Details of neonatal course and outcome were for Those antenatally diagnosed with severe CHD who were born born before 36 weeks gestation. Results: Bet ween January 1998 and December 2002,9918 women were referred for fetal echocardiography. Serious CHD was diagnosed in 1191 fetuses (12%), of which 46 (4%) de livered prematurely.Median gestation was 33 (range 24-35) weeks, and median birth weight 1.56 (0.50-3.59) kg.Extracardiac / karyotypic anomalies occurred in 23 (50%). Twenty-six babies 57%) underwent neonatal surgery: 16 a cardiac pr ocedure, 5 a general surgical procedure, and 5 both. Died died or after operation (31%). Two babies underwent interventional heart catheterization; 72% .Extracardiac / karyotypic anomali es i ncreased the relative risk of death by a factor of 1.36.Mean hospital stay for those surviving to initial discharge was 46 (2-137) days. Conclusions: There is a very high morbidity and mortality rate in this group, particularly for those with extracardiac / karyotypic anomalies. This should be reflected in decision ov er elective preterm delivery and when counseling parents.