title: Neonatal management and outcomes of prenatally diagnosed CHDs.
abstract: OBJECTIVE
  The aim of this study was to determine the probability of intervention at birth after prenatal diagnosis of CHD.
  
  
  METHODS
  A 10-year retrospective study including all foetuses with a prenatally diagnosed CHD and those delivered in a tertiary-care cardiac centre between January, 2002 and December, 2011 was carried out. Patients were classified into eight groups according to the anticipated risk of neonatal intervention.
  
  
  RESULTS
  The need for urgent intervention and/or PGE1 infusion within the first 48 hours of life was 47% (n=507/1080): 72% (n=248) for CHD at risk for a Rashkind procedure, 77% (n=72) for CHD with ductal-dependent pulmonary flow, 13% (n=22) for CHD with potentially ductal-dependent pulmonary flow, 94% (n=62) for CHD with ductal-dependent systemic flow, 29% (n=88) for CHD with potentially ductal-dependant systemic flow, 50% (n=4) for total anomalous pulmonary venous connection, and 17% (n=1) for CHD with atrio-ventricular block. In all, 34% of the patients received PGE1 infusion and 21.4% underwent urgent catheter-based or surgical interventions; 10% of patients without anticipated risk (n=10) underwent an early intervention; 6.7% (n=73) of the patients died; and 55% (n=589) had an intervention before discharge from hospital.
  
  
  CONCLUSIONS
  Half of the neonates with foetal CHD benefited from an urgent intervention or PGE1 infusion at birth. We recommend scheduled delivery and in utero transfer for transposition of the great arteries, double-outlet right ventricle with sub-pulmonary ventricular septal defect, total anomalous pulmonary venous connection, CHD with atrio-ventricular block with heart rate <50, all ductal-dependant lesions, and CHD with potentially ductal-dependant systemic flow.
authors.affiliation: 1Hôpital Necker Enfants malades,APHP,Centre de référence Malformations Cardiaques Congénitales Complexes - M3C,Paris,France.
authors.forename: Myriam
authors.initials: M
authors.lastname: Bensemlali
authors.affiliation: 1Hôpital Necker Enfants malades,APHP,Centre de référence Malformations Cardiaques Congénitales Complexes - M3C,Paris,France.
authors.forename: Fanny
authors.initials: F
authors.lastname: Bajolle
authors.affiliation: 3Cardiologie Pédiatrique,Centre Chirurgical Marie Lannelongue,Le Plessis Robinson,France.
authors.forename: Daniela
authors.initials: D
authors.lastname: Laux
authors.affiliation: 1Hôpital Necker Enfants malades,APHP,Centre de référence Malformations Cardiaques Congénitales Complexes - M3C,Paris,France.
authors.forename: Pauline
authors.initials: P
authors.lastname: Parisot
authors.affiliation: 1Hôpital Necker Enfants malades,APHP,Centre de référence Malformations Cardiaques Congénitales Complexes - M3C,Paris,France.
authors.forename: Magalie
authors.initials: M
authors.lastname: Ladouceur
authors.affiliation: 1Hôpital Necker Enfants malades,APHP,Centre de référence Malformations Cardiaques Congénitales Complexes - M3C,Paris,France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Fermont
authors.affiliation: 1Hôpital Necker Enfants malades,APHP,Centre de référence Malformations Cardiaques Congénitales Complexes - M3C,Paris,France.
authors.forename: Marilyne
authors.initials: M
authors.lastname: Lévy
authors.affiliation: 1Hôpital Necker Enfants malades,APHP,Centre de référence Malformations Cardiaques Congénitales Complexes - M3C,Paris,France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Le Bidois
authors.affiliation: 1Hôpital Necker Enfants malades,APHP,Centre de référence Malformations Cardiaques Congénitales Complexes - M3C,Paris,France.
authors.forename: Francesca
authors.initials: F
authors.lastname: Raimondi
authors.affiliation: 2Université Paris Descartes,Sorbonne Paris Cité,Paris,France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Ville
authors.affiliation: 2Université Paris Descartes,Sorbonne Paris Cité,Paris,France.
authors.forename: Laurent J
authors.initials: LJ
authors.lastname: Salomon
authors.affiliation: 1Hôpital Necker Enfants malades,APHP,Centre de référence Malformations Cardiaques Congénitales Complexes - M3C,Paris,France.
authors.forename: Younes
authors.initials: Y
authors.lastname: Boudjemline
authors.affiliation: 1Hôpital Necker Enfants malades,APHP,Centre de référence Malformations Cardiaques Congénitales Complexes - M3C,Paris,France.
authors.forename: Damien
authors.initials: D
authors.lastname: Bonnet
mesh_terms: D000328:Adult; D019468:Disease Management; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal / Q000379:methods*; D055815:Young Adult
keywords: CHD; in utero transfer; outcome