title: [Complex Congenital Heart Disease: The Influence of Prenatal Diagnosis].
abstract: BACKGROUND
  Complex congenital heart disease is a group of severe conditions. Prenatal diagnosis has implications on morbidity and mortality for most severe conditions. The purpose of this work was to evaluate the influence of prenatal diagnosis and distance of residence and birth place to a reference center, on immediate morbidity and early mortality of complex congenital heart disease.
  
  
  METHODS
  Retrospective study of complex congenital heart disease patients of our Hospital, born between 2007 and 2012.
  
  
  RESULTS
  There were 126 patients born with complex congenital heart disease. In 95%, pregnancy was followed since the first trimester, with prenatal diagnosis in 42%. There was a statistically significant relation between birth place and prenatal diagnosis. Transposition of great arteries was the most frequent complex congenital heart disease (45.2%), followed by pulmonary atresia with ventricular septal defect (17.5%) and hypoplastic left ventricle (9.5%). Eighty-two patients (65.1%) had prostaglandin infusion and 38 (30.2%)were ventilated before an intervention. Surgery took place in the neonatal period in 73%. Actuarial survival rate at 30 days, 12 and 24 months was 85%, 80% and 75%, respectively. There was no statistically significant relation between prenatal diagnosis and mortality.
  
  
  CONCLUSIONS
  Most patients with complex congenital heart disease did not have prenatal diagnosis. All cases with prenatal diagnosis were born in a tertiary center. Prenatal diagnosis did not influence significantly neonatal mortality, as already described in other studies with heterogeneous complex heart disease.
  
  
  CONCLUSIONS
  prenatal diagnosis of complex congenital heart disease allowed an adequate referral. Most patients with complex congenital heart disease werenâÄôt diagnosed prenatally. This data should be considered when planning prenatal diagnosis of congenital heart disease.
authors.affiliation: Serviço de Pediatria. Hospital Vila Franca de Xira. Vila Franca de Xira. Portugal.
authors.forename: Marta
authors.initials: M
authors.lastname: Correia
authors.affiliation: Serviço de Pediatria. Hospital de Caldas da Rainha. Centro Hospitalar Oeste. Caldas da Rainha. Portugal.
authors.forename: Fabiana
authors.initials: F
authors.lastname: Fortunato
authors.affiliation: Serviço de Cardiologia Pediátrica. Hospital de Santa Cruz. Centro Hospitalar de Lisboa Ocidental. Lisboa. Portugal.
authors.forename: Duarte
authors.initials: D
authors.lastname: Martins
authors.affiliation: Serviço de Cardiologia Pediátrica. Hospital de Santa Cruz. Centro Hospitalar de Lisboa Ocidental. Lisboa. Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Teixeira
authors.affiliation: Serviço de Cardiologia Pediátrica. Hospital de Santa Cruz. Centro Hospitalar de Lisboa Ocidental. Lisboa. Portugal.
authors.forename: Graça
authors.initials: G
authors.lastname: Nogueira
authors.affiliation: Serviço de Cardiologia Pediátrica. Hospital de Santa Cruz. Centro Hospitalar de Lisboa Ocidental. Lisboa. Portugal.
authors.forename: Isabel
authors.initials: I
authors.lastname: Menezes
authors.affiliation: Serviço de Cardiologia Pediátrica. Hospital de Santa Cruz. Centro Hospitalar de Lisboa Ocidental. Lisboa. Portugal.
authors.forename: Rui
authors.initials: R
authors.lastname: Anjos
mesh_terms: D005260:Female; D006297:Health Services Accessibility; D006330:Heart Defects, Congenital / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D012017:Referral and Consultation; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal