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| SIGNIFICANCE
OF NEONATAL SCREENING FOR CONGENITAL HEART DISEASE |
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H. Begić, E. Kabil, H. Tahirović, F. Skokić and G. Mehikić
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| Pediatric
Clinic, Clinic for Cardiovascular Diseases, Department of
Neonatology, Gynecology Obstetric Clinic, Clinical Center
University of Tuzla, Bosnia and Herzegovina |
The necessary
condition for timely and adequate treatment of congenital heart
disease (CHD) is their early detection. In most developed countries
neonatal screening for CHD is part of the child health care program
for a long time. We began with systematic screening for CHD in
1999 on collaboration with Department of Neonatology, Gynecology
Obstetric Clinic in Tuzla in which was born 86% children in Tuzla
Canton. The program consists of looking for suspect CHD on the
basis of established criteria in children up to 7 days old and
their cardiologist evaluation in the Ambulance of Pediatric Cardiology,
Pediatric Clinic in Tuzla. The aim of the study was evaluation
of the significance of two years work screening program at University
Clinical Center in Tuzla. Method of work was retrospective analysis
of medical documentation of children with diagnosed CHD by neonatal
screening and clinical evaluation during neonatal period in 1999
and 2000. Control group of subjects contained children with diagnosed
CHD during neonatal period in 1997 and 1998. Neonatal screening
in 1999 and 2000 included 10637 liveborn. In 195 of them CHD was
suspected and in 71 (6,68%) CHD was diagnosed, what is statistically
significant increase (p<0,001) in relation to period before screening
was established, when 76 out of 11210 liveborn was evaluated,
and in only 12 (1,07%) CHD was diagnosed. Analyzing structure
of CHD during period of screening, increase of ventricular septal
defect, pulmonary stenosis and critical heart anomalies is evident.
Critical CHD was discovered in 15 newborn, 7 of them had a surgery
and 8 of them died, what was different than in previous period
when 7 of 8 detected newborn with critical CHD died and only one
had a surgery. Based on results we can notice important efficiency
of neonatal screening in early diagnosing of CHD. At same time,
results point on necessary establishing of screening in fetal
and infant period, appliance in other regions and on need for
organizing futher adequate treatment of children with these anomalies
in our country.
Keywords: Screening, neonatal, congenital heart disease.
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