Abstract
Introduction: The complete routine neonatal examination before discharge of the newborn baby is the simplest and earliest way to identify possible heart lesions. Objective: The aim of this study was to ascertain the clinical significance of precordial murmurs heard on routine neonatal examination Design: Descriptive, cross sectional study design was applied at routine neonatal examination before discharge of the neonate Method: All consecutive 4,804 live born neonates (excluding those dying before neonatal evaluation) at non-university units of the De Soysa Hospital for Women (DSHW) during a ten month period from 15.05.2013 were screened within 24 hours of birth for precordial murmurs and those with audible murmurs were then referred for echocardiography Results: Prevalence of murmurs and CHD at routine neonatal examination was 16 per 1,000 live births and 15 per 1,000 live births respectively. The most common lesions found in echocardiographic evaluation were atrial septal defect (62%), patent ductus arteriosus (26%), ventricular septal defect (19%) and cyanotic heart with multiple lesions (12%). Conclusions: At routine neonatal examination, prevalence of murmurs was 1.6% and the prevalence of CHD was 15 per 1,000 live births. If a murmur was heard, there was a 96% chance that the neonate could have CHD. Sri Lanka Journal of Child Health , 2015; 44 (1): 24-30 DOI: http://dx.doi.org/10.4038/sljch.v44i1.7959
Highlights
The complete routine neonatal examination before discharge of the newborn baby is the simplest and earliest way to identify possible heart lesions
The most common lesions found in echocardiographic evaluation were atrial septal defect (62%), patent ductus arteriosus (26%), ventricular septal defect (19%) and cyanotic heart with multiple lesions (12%)
All consecutive live born babies, excluding those who died before neonatal evaluation in the 3 non-university maternity units at De Soysa Hospital for Women (DSHW) during the ten month period from 15th May 2013 to 15th March 2014 were prospectively taken as the study sample
Summary
The complete routine neonatal examination before discharge of the newborn baby is the simplest and earliest way to identify possible heart lesions. Congenital heart disease (CHD) is defined as a structural abnormality of the heart or intrathoracic great vessels that is or potentially of functional significance[1]. CHD is the leading cause of infant deaths due to birth defects[2]. 1. Severe CHD includes cyanotic CHD such as dtransposition of the great arteries, tetralogy of Fallot, hypoplastic right heart or left heart, single ventricle (SV), double outlet right ventricle (DORV), truncus arteriosus, total anomalous pulmonary venous connection (TAPVC), critical pulmonary stenosis (PS) and acyanotic CHD such as atrio-ventricular septal defect (AVSD), large ventricular septal defect (VSD), large patent ductus arteriosus (PDA), critical or severe aortic stenosis (AS), severe PS and critical coarctation. 2. Moderate CHD includes mild or moderate AS or aortic incompetence (AI), moderate PS or incompetence, noncritical coarctation, large atrial septal defect (ASD) and complex forms of VSD
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