Aim: Our study aimed to review the safety profile of the echocardiography service provided by the neonatologist in our hospital. Until recently, echocardiography was the domain of paediatric cardiologists; today, neonatologists commonly use it to diagnose and manage newborns in many tertiary neonatal units. We achieved this by reviewing the indications and outcomes of neonatal echocardiography.
Method: We conducted a retrospective analysis of all neonatal echocardiograms performed between April 2013 and December 2016 at our institution. Data were collected on indications, echocardiographic diagnoses, and comparisons with findings from either a general paediatrician with cardiology expertise or a paediatric cardiologist from the regional referral hospital. Patients with minor diagnoses were followed locally, while those with critical congenital heart disease were referred to the regional centre for confirmation and further management. No follow-up was arranged for patients with normal cardiac anatomy, and their medical records were reviewed for any subsequent cardiac concerns post discharge.
Results: A total of 232 patients underwent 258 echocardiograms. Indications included asymptomatic heart murmur (35.7%), ruling out congenital heart disease and functional assessment (24%), follow-up/management of patent ductus arteriosus (14.7%), and presence of multiple congenital abnormalities (12.9%). Critical congenital heart disease was found in 12% of the cases, with 70% complete and 26% partial concordance with cardiologist reviews. Among non-critical cases (38.8%), 98% had findings concordant with follow-up echocardiograms. None of the patients with normal cardiac anatomy (42.7%) had post-discharge cardiac concerns within the first year of life.
Conclusion: Our results indicate that it is appropriate to provide cardiology services by a neonatologist, as findings were consistently compared and confirmed with those of trained paediatric cardiologists or specialists. It is also important to have regional referral unit support for advice and further management plans.
Keywords: congenital heart disease; echocardiography in neonates; neonatal echocardiography; point-of-care ultrasound (pocus); tertiary nicu care.
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