Echocardiographic screening for congenital heart disease: a randomized study
-
A. Sands
Abstract
Objectives: To assess the effectiveness and potential cost of an echocardiographic screening program for congenital heart disease (CHD).
Patients and methods: Between 01/11/94 and 28/02/98 there were 9697 deliveries in The Royal Maternity Hospital Belfast. Mothers were randomized before delivery. 4875 infants were allocated to the scan group, while 4822 were assigned to clinical assessment alone. High-risk infants were considered separately. Cases of CHD detected before hospital discharge were documented. The annual cost of screening was estimated and the time to accurate diagnosis in each group was assessed.
Results: During the study 124 scan allocated infants and 50 controls were identified as having significant CHD before hospital discharge. With a minimum of 3 years follow-up there were 27 additional late diagnoses in controls and 1 in scanned infants. During a single year of the study the mean time to complete diagnosis was 2 days for scanned cases and 110 in controls. The projected cost of screening for all infants was £ 22/infant for the first year.
Conclusions: Adding echocardiography to clinical examination greatly enhances early detection of CHD. Although screening is expensive, once established it may reduce the cost of unnecessary outpatient referrals.
Copyright © 2002 by Walter de Gruyter GmbH & Co. KG
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Articles in the same Issue
- Taurine and taurine-deficiency in the perinatal period
- The effect of betamethasone administration to pregnant women on maternal serum indicators of infection
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- Increased endothelial thrombomodulin (TM) expression in pregnancies complicated by IUGR
- Serum amyloid A protein in the early detection of late-onset bacterial sepsis in preterm infants
- Carbon dioxide levels do not predict duration of home oxygen requirement: a retrospective study
- A congenital anterior diaphragmatic hernia with massive pericardial effusion requiring neither emergency pericardiocentesis nor operation. A case report and review of the literature
- Extravascular collection of fluid around the vertebra resulting from malpositioning of a peripherally inserted central venous catheter in extremely low birth weight infants
- Placental boost to varicella-zoster antibodies in the newborn
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- Congress Calendar
- WAPM-Newsletter No 2/2002
