A. Sands, B. Craig, C. Mulholland, C. Patterson, J. Dornan, F. Casey
Echocardiographic screening for congenital heart disease: a randomized study
Objectives: To assess the effectiveness and potential cost
of an echocardiographic screening program for congenital
heart disease (CHD).
Patients and methods: Between 01/11/94 and 28/02/98
there were 9697 deliveries in The Royal Maternity Hospital
Belfast. Mothers were randomized before delivery.
4875 infants were allocated to the scan group, while 4822
were assigned to clinical assessment alone. High-risk infants
were considered separately. Cases of CHD detected
before hospital discharge were documented. The annual
cost of screening was estimated and the time to
accurate diagnosis in each group was assessed.
Results: During the study 124 scan allocated infants and
50 controls were identified as having significant CHD before
hospital discharge. With a minimum of 3 years follow-up there were 27 additional late diagnoses in controls
and 1 in scanned infants. During a single year of the
study the mean time to complete diagnosis was 2 days for
scanned cases and 110 in controls. The projected cost of
screening for all infants was £ 22/infant for the first year.
Conclusions: Adding echocardiography to clinical examination
greatly enhances early detection of CHD. Although
screening is expensive, once established it may
reduce the cost of unnecessary outpatient referrals.
Journal of Perinatal Medicine, Walter de Gruyter
Print ISSN: 1619-3997
Volume: 30, 07/2002
Pages: 307 - 312
Show full article (external site)
Show all available items of this journal
Search
