G83 Neonatal Echocardiography by Neonatologists: Experience So Far

Background Neonatal Echocardiography is an important investigation for assessment and clinical management of sick preterm neonate and is also essential for diagnosis of congenital heart disease. Not all neonatal intensive care units are equipped with paediatric cardiology services. Many units in UK and internationally have neonatologists doing in house echocardiograms in their units and outpatient murmur clinics. This is one of the largest study which aims to access the validity of echocardiograms done by the neonatologists compared to the cardiologists. Methods This is a retrospective study over a 7½ year period in a level 3 neonatal intensive care unit. Echocardiograms were performed either in neonatal unit or outpatient murmur clinics. Selected abnormal examinations were referred to regional cardiology services. Database of all the scans were maintained electronically. This neonatal database was compared with regional paediatric cardiology database called Cardiobase ® to assess concordance and discordance of the findings in referred patients. Results A total of 2325 scans were performed on 1639 neonates from 1st September 2003 till 31st December 2011. Cardiobase ® data was available for 454 scans. Concordance was found in 91.8% of these scans and partial concordance was found in further 4.4% of scans. 31 infants (1.6% of total infants scanned) had critical structural abnormalities and all of these were identified correctly. 3.7% of the scans had discordant findings and most of these were false positives and they were referred to exclude critical events. Six scans had had false negative findings. Sensitivity and specificity for the scans done by neonatologists was 98%. Conclusion Neonatal echocardiography by neonatologists have high concordance rates and have a high sensitivity and specificity in detecting congenital heart diseases. With appropriate Paediatric Cardiology support Neonatal Echocardiography by neonatologists can be a safe and reliable tool.