Benefício do diagnóstico pré-natal na transposi？？o das grandes artérias

objective:to study the impact of prenatal diagnosis (pnd) of transposition of the great arteries (tga) on perioperative morbidity and mortality in a pediatric cardiology center. methods: retrospective study of newborns (nb) with sim-ple tga, with and without pnd, who underwent corrective sur-gery, between january 2007 and july 2010. the following vari-ables were analysed: clinical characteristics of the patients, age at surgery, duration of circulatory arrest, and outcome. statistical analysis included the student t and the x2 tests. statistical signifi-cance was assessed by use of a cutoff value of p =0,05. results: among a total of 31 nb with tga we isolated 17 cases of simple tga, six with pnd (group 1) and 11 with neo-natal diagnosis (group 2). deliveries of group 1 were all in terti-ary hospital by caesarean section. the nb of group 2 started prostaglandins at a mean time of 26,7 hours (h). the rashkind procedure was carried out at a mean time of 27,2h vs 55,1h. in the second group the intensive care unit (icu) admission occurred at 20,4h. the minimum oxygen saturation in preoperative varied between 82-95% vs 30-80%. in the first group 16,7% of the nb had preoperative metabolic acidosis vs 54,5% and maximum creatinine value varied between 0,5-0,8 mg/dl vs 0,6-1,1. the surgeries of the 1st group occurred on average at 9,0 days (d) of life vs 11,5d. extra-corporal circulation and ventilation sup-port durations were similar in both groups. the mean icu stay was 4,7d vs 7,4d and the mean total hospital stay was 12,0d vs 29,9d. complications in postoperative period: group 1 - cardiac tamponade (1), necrotizing enterocolitis (1); group 2: ventricular fibrillation (1), compressive hemothorax (1), transitory complete atrioventricular block (1), sepsis (1), diaphragm paresis (1), peri-cardial effusion (1) and death (1). conclusion: the pnd of tga allowed us to schedule delivery in optimal conditions and provide adequate management, avoiding complications such as prolong