Diagnosis of severe congenital heart defects in Norway 2016. / Diagnostikk av alvorlige medfødte hjertefeil i Norge 2016.

BACKGROUND: Most structural congenital heart defects can be identified prenatally through ultrasound examination in pregnancy or via routine examinations during hospital maternity stays, but in some cases, heart defects are not discovered prior to discharge. There has been little previous research into detection rates with the various methods available. In this study, we have examined the timing and method of diagnosis of severe congenital heart defects. MATERIAL AND METHOD: All children with severe heart defects born in Norway in 2016 and registered at Oslo University Hospital were included in this study. In addition, information on committee-handled abortions (after the 12th week of pregnancy) was obtained from the Medical Birth Registry of Norway. RESULTS: In total, 105 of 181 (58 %) severe heart defects were diagnosed prenatally, and 51 (28 %) pregnancies were terminated. Among the 73 live-born children with severe heart defects that went unrecognised prenatally, 33 (45 %) of the heart defects were discovered outside of routine examinations and 9 (12 %) after discharge from hospital. Coarctation of the aorta was the most common diagnosis in cases of late-detected heart defects. INTERPRETATION: This first national study of the diagnosis of severe congenital heart defects in Norway shows that most severe congenital heart defects are discovered prior to discharge from hospital after birth. However, almost half are diagnosed outside of routine examinations, and in some cases the diagnosis is not made until after discharge. The results indicate a need for new studies and for a quality registry of congenital heart defects to further improve diagnosis and early treatment.

Survey of 23 Nordic university hospitals showed that 77% lacked written procedures for measuring and interpreting blood pressure in infants.

AIM: This study determined the use of standardised procedures for infant noninvasive blood pressure (NIBP) measurements in the Nordic countries and aimed to identify factors included in the standardisation and interpretation of NIBP measurements in infants. METHODS: A cross-sectional electronic questionnaire survey was sent to 84 physicians in all 23 university hospitals in Sweden, Norway, Denmark, Finland and Iceland and was completed from February to March 2017. The survey contained respondent characteristics, the presence and description of standardised procedures for NIBP measurements, daily practice of NIBP measurements and methodological considerations and interpretation of NIBP measurements in a healthy six-month-old child. RESULTS: We received responses from 55 of 84 physicians working in all 23 Nordic university hospitals, in paediatric cardiology (n = 22), general paediatrics (n = 16), paediatric nephrology (n = 14) and other fields (n = 3). Less than a quarter (23%) said their hospital issued specific NIBP procedures relating to infants and they referred to 19 different sources of information. The factors that were most commonly assessed for interpretation were age (100%), arousal state (78%) and cuff size (76%). CONCLUSION: Most of the university hospital units treating children lacked age-specific written procedures for measuring and interpreting infant NIBP, and there is a strong need for common Nordic guidelines.