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Second Congress of Cardiology and Angiology of Bosnia & Herzegovina

 

SIGNIFICANCE OF NEONATAL SCREENING FOR CONGENITAL HEART DISEASE
H. Begić, E. Kabil, H. Tahirović, F. Skokić and G. Mehikić
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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