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Is routine preoperative transthoracic echocardiography necessary in newborns with myelomeningocele?

Journal of Perinatology volume 35, pages 842–845 (2015)Cite this article

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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.

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Acknowledgements

The authors would like to thank Richard Kronmal, PhD for his statistical expertise, and David Shurtleff, MD and William Walker, MD for their assistance with study design. TDS is supported by Award K23NS062900 from the National Institute of Neurological Disorders and Stroke, the Child Health Corporation of America via the Pediatric Research in Inpatient Setting Network Executive Council, and Seattle Children’s Center for Clinical and Translational Research, and CTSA Grant Number ULI RR025014 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH). None of the sponsors participated in design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the NCRR or NIH.

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Authors and Affiliations

  1. Division of Cardiology, Department of Pediatrics, University of Washington/Seattle Children’s Hospital, Seattle, WA, USA

    M M Vernon & A H Schultz

  2. Division of Developmental Medicine, Department of Pediatrics, Madigan Army Medical Center, Tacoma, WA, USA

    D Powell

  3. Division of Developmental Medicine, Department of Pediatrics, University of Washington/Seattle Children’s Hospital, Seattle, WA, USA

    D Powell & D Doherty

  4. Division of Hospital Medicine, Department of Pediatrics, University of Washington/Seattle Children’s Hospital, Seattle, WA, USA

    T D Simon

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  1. M M Vernon
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  2. D Powell
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Correspondence to M M Vernon.

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Vernon, M., Powell, D., Schultz, A. et al. Is routine preoperative transthoracic echocardiography necessary in newborns with myelomeningocele?. J Perinatol 35, 842–845 (2015). https://doi.org/10.1038/jp.2015.74

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