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==Overview==
==Overview==
Effective measurement for primary prevention include prenatal [[echocardiography]] and [[genetic]] testing for detecting [[cyanotic congenital heart disease]] and prenatal [[corticosteroid]] therapy for prevention of neonatal [[respiratory distress syndrome]] and development of lung maturation.


== Prenatal diagnosis ==
== Primary prevention ==
* Most congenital heart defects can be identified by [[Echocardiography|fetal echocardiography.]]
* Guidelines of the International Society for Ultrasound in Obstetrics and Gynecology recommends [[Ultrasonogram|Ultra Sound]] assessment of the outflow tracts. [41].
* Less than half of patients with critical [[Congenital heart disease|congenital heart defects]] were routinely identified. [10,42-44].


=== Antenatal corticosteroid therapy ===
*Effective measurement for primary prevention include prenatal [[echocardiography]] and [[genetic]] testing for detecting [[cyanotic congenital heart disease]] and prenatal [[corticosteroid]] therapy for prevention of neonatal [[respiratory distress syndrome]] and development of lung maturation.<ref name="LiuXu2019">{{cite journal|last1=Liu|first1=Xiwang|last2=Xu|first2=Weize|last3=Yu|first3=Jiangen|last4=Shu|first4=Qiang|title=Screening for congenital heart defects: diversified strategies in current China|journal=World Journal of Pediatric Surgery|volume=2|issue=1|year=2019|pages=e000051|issn=2516-5410|doi=10.1136/wjps-2019-000051}}</ref>
* Antenatal [[Corticosteroid|corticosteroid therapy]] should be administered to all pregnant women at 23 to 34 weeks who are at increased risk of [[Premature birth|preterm delivery]] within the next seven days to prevent or decrease the severity of [[RDS|neonatal RDS]].
* [[Corticosteroid|Coericosteroids]] enhances maturational changes in fetal lung architecture and biochemistry with increased synthesis and release of [[surfactant]], resulting in improved neonatal lung function.  


=== Assisted ventilation techniques ===
* Respiratory support that prevents and reduces [[atelectasis]] should be administered to all preterm infants who are at risk for [[RDS]].
* The less invasive modalities have replaced intubation and mechanical ventilation as the initial intervention that provides positive pressure to reduce the risk of atelectasis. Nasal continuous positive airway pressure (nCPAP) is the preferred modality to provide positive end-expiratory pressure.
* Intubation and mechanical ventilation with PEEP may be needed in case of failed previous maneuvers.
* Prophylactic caffeine therapy is recommended in extremely low birth weight infants (BW <1000 g) as these patients universally will have apnea of prematurity and are at greatest risk for developing BPD. 17.
* Other indications for mechanical ventilation include: 
* Respiratory acidosis, documented by an arterial pH <7.2 and partial pressure of arterial carbon dioxide (PaCO2) >60 to 65 mmHg
* Hypoxemia documented by an arterial partial pressure of oxygen (PaO2) <50 mmHg despite oxygen supplementation, or when the fraction of inspired concentration (FiO2) exceeds 0.40 on nCPAP
* Severe apnea
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Latest revision as of 17:55, 6 November 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Effective measurement for primary prevention include prenatal echocardiography and genetic testing for detecting cyanotic congenital heart disease and prenatal corticosteroid therapy for prevention of neonatal respiratory distress syndrome and development of lung maturation.

Primary prevention

References

  1. Liu, Xiwang; Xu, Weize; Yu, Jiangen; Shu, Qiang (2019). "Screening for congenital heart defects: diversified strategies in current China". World Journal of Pediatric Surgery. 2 (1): e000051. doi:10.1136/wjps-2019-000051. ISSN 2516-5410.

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