Our findings showed that heterotaxy-CHD patients with CD may have increased risks for respiratory deficiencies. Overall, there was a trend toward increased mortality in CD patients with intermediate follow-up evaluation. Because β-agonists are known to increase ciliary beat frequency, presurgical screening for CD and perioperative treatment of CD patients with inhaled β-agonists may improve postoperative outcomes and survival.
The American Academy of Pediatrics recently published evidence-based guidelines for a standardized approach to pulse oximetry as a screening tool for critical congenital heart disease (CCHD). The addition of CCHD screening to the standard newborn examination may lead to earlier detection of CCHD and subsequently decreased morbidity and mortality. We report a case of CCHD with excessive pulmonary blood flow that went undetected during routine newborn screening. Healthcare practitioners and families need to be aware of the limitations of CCHD screening.
When performed by a trained sonographer, fetal echocardiography can be instrumental in identifying cardiac pathology and abnormal cardiac physiology before a baby is born. Even though the diagnostic accuracy of a fetal echocardiogram can be limited by maternal body habitus, gestational age, and fetal position, sequential exams allow for detailed analysis of the cardiac structures. Early identification and diagnosis of intrauterine cardiac anomalies and subsequent pregnancy management and delivery planning are essential to providing the best possible outcome for fetuses born with heart defects. In this case study, we describe a rare combination of congenital heart defects diagnosed in an uncontrolled type 1 diabetic mother while in her second trimester of pregnancy.
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