3.2 Neonatal outcomes
Neonatal outcomes are summarized in Table 3. Eighteen neonates (37.5%)
required urgent BAS, immediately after birth (n=13, 27.1%), on the
first day after delivery (n=4, 8.3%) and on the second day after
delivery (n=1, 2.1%).
On prenatal echocardiography, only 3 of 13 fetuses requiring urgent BAS
immediately after birth had VSD. In these 13 fetuses, the median FO
diameter was 5.1 mm (IQR 1.6). Of four fetuses requiring urgent BAS on
the first day of life, only one had VSD. In these 4 fetuses, the median
FO diameter was 5.1 mm (IQR 0.4). The remaining fetus that required
urgent BAS on the second day of life had an IVS with a median FO
diameter of 5.4 mm (IQR 0). All 5 fetuses with a restrictive FO
appearance and an IVS underwent urgent BAS immediately after birth. In
these fetuses, the median FO diameter was 4.1 mm (IQR 0.3).
Non-urgent BAS was performed in 5 neonates (10.4%) beyond 48 hours of
life due to postnatal echocardiographic detection of left ventricular
outflow tract obstruction (subvalvular pulmonary stenosis). The median
time to non-urgent BAS was 15 days (IQR 6). All the fetuses undergoing
non-urgent BAS had VSD, with a median FO diameter of 6.3 (IQR 3.2) mm.
None underwent arterial switch operation. One neonate underwent Rastelli
operation at 11 months, another underwent Nicaidoh operation at 15
months, and another underwent Glenn operation at 24 months. The
remaining two newborns were under follow-up.
In total, 43 neonates underwent arterial switch operation, 18 of whom
required urgent BAS. The median FO diameter was 5.1 mm (IQR 1.6) in the
urgent BAS group as compared with 6.3 mm (IQR 1.3) in fetuses without
urgent BAS.