Congenital heart disease with neonatal revelation in Tunisia: Epidemiological, clinical and evolutionary aspects

Abstract

Congenital heart diseases include all heart and vascular malformations; they represent around third of congenital malformations and constitute an important public health issue in Tunisia. The aim of this study is to describe the epidemiological and clinical profile of these malformations and to emphasize on the results encountered through the disease treatment. We propose a retrospective study of 165 congenital heart disease observations collected in the neonatology department of the maternity and neonatology center of Tunis over a period of 2 years from January 2018 to December 2019. The hospital prevalence of congenital heart disease was equal to 3.5%. The sex ratio was equal to 1.11 (52.7% male, 47.2% female). Inbreeding was found in 10.9% of patients. The average maternal age was equal to 33 years; the follow-up of the pregnancy was noted in 60.2% of mothers. Chronic diseases were found in 13.3% (type 1 diabetes 6%); 61.2% of heart diseases were diagnosed in antenatal care. Respiratory distress was the most common symptom (86.6%). Hypotrophy was objectified in 11.5% of newborns however the rate of association of heart murmur and congenital heart disease was 45.4%. Among the patients, 28.4% had associated congenital malformations. Non-cyanogenic congenital heart disease represented 63.3%, however, it represented 36.3% for the cyanogenic ones. Among the patients, 67.6% received medical treatment, 12.7% benefited from surgery or interventional surgery and 86.7% of them received treatment in an intensive care setting. The mortality rate was 64.8%. Congenital heart disease is still shown a significant rate of mortality and morbidity. Improving the prognosis is based on prenatal screening in women at risk in order to be able to develop genetic counselling and to practice a therapeutic termination of pregnancy when it is necessary.