Which neonates should have a pre-operative echocardiography? Findings from a national survey and a retrospective tertiary single-centre analysis in the United Kingdom
Topic overview
This UK study reveals lack of standardized criteria for pre-operative echocardiography in neonates undergoing surgery. Analysis of 454 cases shows that while antenatal screening misses significant CHD, normal postnatal clinical examination reliably excludes major cardiac defects, suggesting targeted echo protocols may optimize detection.
Key takeaways
- 88.5% of UK paediatric surgical centres lack established criteria for pre-operative neonatal echocardiography, showing significant practice variation.
- 8.8% of neonates undergoing surgery had CHD; abnormal foetal screening missed 54% of major/moderate cases (46% sensitivity).
- Normal postnatal clinical examination has 100% sensitivity and 100% NPV for ruling out major/moderate CHD before neonatal surgery.
- Medical/surgical conditions associated with CHD had low PPV (35%, 6%) but high NPV (98%) for detecting significant cardiac anomalies.
- Standardized pre-operative echo criteria based on clinical exam and high-risk conditions could improve CHD detection in neonatal surgery.
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How to cite: GlobalCastMD. Which neonates should have a pre-operative echocardiography? Findings from a national survey and a retrospective tertiary single-centre analysis in the United Kingdom. GlobalCastMD Medical Library. 2024-07-04. https://dev.library.globalcastmd.com/article/8802?via_space=staycurrentmd
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