Neonatal management of prenatally suspected coarctation of the aorta.
Adult
Aorta
/ diagnostic imaging
Aortic Coarctation
/ diagnosis
Case-Control Studies
Echocardiography
Female
Gestational Age
Humans
Infant Care
/ methods
Infant, Newborn
Infant, Newborn, Diseases
/ diagnosis
Male
Postnatal Care
/ methods
Pregnancy
Pregnancy Outcome
/ epidemiology
Retrospective Studies
Treatment Outcome
Ultrasonography, Prenatal
United States
/ epidemiology
Journal
Prenatal diagnosis
ISSN: 1097-0223
Titre abrégé: Prenat Diagn
Pays: England
ID NLM: 8106540
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
07
12
2019
revised:
24
03
2020
accepted:
28
03
2020
pubmed:
12
4
2020
medline:
14
7
2021
entrez:
12
4
2020
Statut:
ppublish
Résumé
(a) To determine the false-positive rate among newborns with prenatally suspected coarctation of the aorta (CoA) within the UCLA Health system, (b) to compare patient and maternal interventions and outcomes between false-positive cases and normal controls, and (c) to determine the timing of clinical presentation of CoA. We performed a single-center, retrospective case control study of all fetuses with suspected isolated CoA who underwent both fetal echocardiographic evaluation and subsequent delivery at UCLA between January 1, 2011, and December 31, 2018. Maternal and neonatal medical records were reviewed for demographic and clinical data, for cases of suspected CoA and for controls. A separate review of our institution's surgical database was performed to identify characteristics of all patients (neonatal and pediatric) with isolated CoA who underwent surgical repair during the same time period. Among the 50 fetal cases of isolated suspected CoA who delivered at our institution, 47 patients (94%) were found to be normal (false positives). Compared with normal controls, patients with suspected CoA were more likely to have delayed maternal bonding, delayed feeding, admission to the intensive care unit, performance of neonatal echocardiograms, initiation of intravenous fluids and initiation of prostaglandin E1, and a longer length of hospital stay. Among the 38 patients undergoing CoA repair at our institution during the study period, four patients were prenatally diagnosed and no patient presented clinically with symptoms before 48 hours after delivery. Compared with normal controls, patients with prenatally suspected coarctation are more likely to have delayed maternal bonding, delayed feeding, more frequent neonatal echocardiograms, and longer length of hospital stay. Further refinement of neonatal management may improve postnatal care.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
942-948Informations de copyright
© 2020 John Wiley & Sons, Ltd.
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