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Is Routine Preoperative Transthoracic Echocardiography Necessary in Newborns with Myelomeningocele?

Overview
Journal J Perinatol
Specialty Gynecology & Obstetrics
Date 2015 Jul 10
PMID 26156062
Citations 3
Authors
M M Vernon
D Powell
A H Schultz
T D Simon
D Doherty
Affiliations
Soon will be listed here.
Abstract

Objective: Congenital heart disease (CHD) is common in newborns with myelomeningocele. Echocardiography before neonatal back closure has been recommended. Its utility in the era of prenatal diagnosis is unclear.

Study Design: We reviewed all newborns with myelomeningocele evaluated by preoperative echocardiography at our institution over 11 years.

Result: Seventy-six successive newborns were identified. Ninety-one percent were prenatally diagnosed with myelomeningocele. In all, 1% had critical, 12% critical or non-critical and 22% critical, non-critical or possible CHD. The single case of critical CHD was both prenatally diagnosed and clinically identifiable.

Conclusion: The prevalence of CHD in newborns with myelomeningocele is increased compared with the general population; however, critical disease is uncommon. We propose preoperative echocardiography is unnecessary when the myelomeningocele is prenatally diagnosed, antenatal cardiac screening is complete and normal, and the newborn is clinically well.

Citing Articles

Which neonates should have a pre-operative echocardiography? Findings from a national survey and a retrospective tertiary single-centre analysis in the United Kingdom.

Chin J, Kelsall A, Jenkins D, Khushu A, Stubbs D, Lynch J Pediatr Surg Int. 2024; 40(1):174.

PMID: 38963543 DOI: 10.1007/s00383-024-05758-1.

Characterizing and quantifying low-value diagnostic imaging internationally: a scoping review.

Kjelle E, Andersen E, Krokeide A, Soril L, van Bodegom-Vos L, Clement F BMC Med Imaging. 2022; 22(1):73.

PMID: 35448987 PMC: 9022417. DOI: 10.1186/s12880-022-00798-2.

Congenital Heart Disease and Myelomeningocele in the Newborn: Prevalence and Mortality.

Wilkes J, Whitehead W, Wang Y, Morris S Pediatr Cardiol. 2021; 42(5):1026-1032.

PMID: 33688980 DOI: 10.1007/s00246-021-02576-3.

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