Lactacidosis in the neonate is minimized by prenatal detection of congenital heart disease.
OBJECTIVE
To investigate the impact of prenatal detection of congenital heart disease on preventing severe preoperative lactacidosis.


METHODS
Patients operated upon for congenital heart disease during the first 31 days of life (n = 209) were studied retrospectively, 21 were diagnosed prenatally and 188 patients had not been diagnosed prenatally. Preoperative lactate, pH and base excess were evaluated.


RESULTS
Differences were noted in preoperative pH (7.28 +/- 0.03 vs. 7.24 +/- 0.01, P = 0.29), base excess (-5.83 +/- 0.64 vs. -6.93 +/- 0.46 mmol/L, P = 0.10) and lactate (3.05 +/- 0.35 vs. 6.08 +/- 0.45 mmol/L, P < 0.001), indicating a significant difference in blood lactate values in favor of the prenatally diagnosed group.


CONCLUSIONS
Prenatal diagnosis of congenital heart disease and the resulting immediate postnatal care prevent lactate increase in the preoperative period of these patients. This may decrease the risk of cerebral damage and result in the patient being in better condition at surgery.
Verheijen
P M
PM
Department of Obstetric, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands.
Lisowski
L A
LA
Stoutenbeek
P
P
Hitchcock
J F
JF
Bennink
G B W E
GB
Meijboom
E J
EJ
D000140:Acidosis, Lactic / Q000517:prevention & control*; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D019344:Lactic Acid / Q000097:blood; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal
D019344:Lactic Acid