title: Outcome of infants with prenatally diagnosed congenital heart disease delivered outside specialist paediatric cardiac centres.
abstract: OBJECTIVE
  To determine the outcome of neonates with a suspected antenatal diagnosis of congenital heart disease (CHD) who were delivered away from a paediatric cardiothoracic centre and were initially managed in a level 3 Neonatal Intensive Care Unit.
  
  
  METHODS
  An 18-year ongoing study conducted in a single institution.
  
  
  RESULTS
  Between 1992 and 2009, 143 fetuses with suspected CHD were identified, and 124 babies were delivered locally. 13 babies with a normal postnatal echocardiogram and six with isolated arrhythmias were excluded from the study. Structural CHD was confirmed in 105 infants; of these, 94 (90%) survived the neonatal period. Of the 11 neonatal deaths, only four of these infants underwent surgery; most had additional risk factors including: prematurity, very low birth weight, and genetic and other structural congenital anomalies.
  
  
  CONCLUSIONS
  This study demonstrates that appropriately selected infants with antenatally diagnosed CHD can be safely delivered and initially managed in a non-cardiac centre during their neonatal period. Deliveries need to be carefully planned with close collaboration among neonatologists, obstetricians, paediatric cardiologists, mid-wives and parents.
authors.affiliation: Neonatal Intensive Care Unit, Box 226, Cambridge University Hospital NHS Trust, Hills Road, NICU BOX 226, Cambridge CB2 2QQ, UK.
authors.forename: Katherine
authors.initials: K
authors.lastname: Anagnostou
authors.forename: Lisa
authors.initials: L
authors.lastname: Messenger
authors.forename: Robert
authors.initials: R
authors.lastname: Yates
authors.forename: Wilf
authors.initials: W
authors.lastname: Kelsall
mesh_terms: D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D008297:Male; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013038:Specialization