Congenital heart diseases with neonatal onset: Prevalence and circumstances of diagnosis in the newborn

Introduction: Congenital heart disease (CHD) is the most common congenital malformation. Their prevalence remains underestimated in our country despite the improvement in diagnostic means. Objective: determine the prevalence and circumstances of diagnosis of CHD in a neonatology department. Materials and methods: We carried out a descriptive cross-sectional study which included all live births with congenital heart disease, in the neonatology department of Hussein Dey University Hospital over a period of seven years (2016-2022). Data collection was done as the diagnosis progressed. We didn’t include non-malformative cardiac abnormalities. Results: We collected 231 cases of congenital heart disease (CHD) out of 66,520 live births (LV), i.e. a prevalence of 3.41‰ LV. Antenatal diagnosis was made in 89 cases (45%). Ultrasound diagnosis was made in 70% of cases in the first 3 days with 46% of cases in the first 24 days of life. Physical signs were dominated by cyanosis in 38%. Congenital heart disease with a high neonatal risk level was in 15 cases (6.5%), including 14 cases of TGV and a single case of total RVPA. Heart disease with a medium to high neonatal risk level was represented by ductal-dependent heart disease in 95 cases (41.3%) of which 30% of cases were straight obstacles including 10.8% T4F. Cardiac diseases with low neonatal risk were in 94 cases (40.8%), of which 38% of cases represented by IVC followed in 29% by AVC and 10.6% by IAC. Conclusions: Given the insufficiency of antenatal diagnosis in our cohort, congenital heart diseases were mainly diagnosed after birth in the face of suggestive clinical symptoms, thus ,The best ways to improve early diagnosis of congenital heart disease would be antenatal screening using fetal echocardiography and the introduction of systematic postnatal screening by the systematic measurement of pre- and post-ductal saturation and the generalization of echocardiography in neonatology departments.