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Indian Journal of Anesthesia and Analgesia

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A Study of Incidence of Congenital Cardiac Anomalies in the NewBorns with Ano-Rectal Malformation: Our Hospital Experience

Aavula Muralidhar, Associate Professor, Department of Anesthesiology, Niloufer Hospital for Women and Child, Osmania Medical Collage, Hyderabad, Telangana 500095, India. , Y.V.S. Ravi Nagaprasad1 , Aavula Muralidhar2

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Indian Journal of Anesthesia and Analgesia 5(12):p 1973-1976, November 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51218.1

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Abstract

  Background: Ano­rectal malformation is a common anomaly seen in newborns and is associated with multiple anomalies like renal, vertebral, muscular and cardiac. Associated cardiac anomalies determine the morbidity and mortality of newborn. It is mandatory to properly evaluate the child for cardiac anomalies in children with ARM. Objective: The aim of the study is to evaluate the incidence of associated cardiac anomalies in thenew­borns with Ano­rectal malformation admitted ina tertiary care centre. Method: Total number of Ano­rectal Malformation admitted from June 2017 to May 2018 in our hospital was recorded. All cases after examination and evaluation were classified into Low ARM and High ARM. All cases after preoperative evaluations and basic haematological tests were taken for emergency colostomy or cut back anoplasty. Patients during postoperative period were performed echocardiogram for cardiac evaluation. Total number newborns with ARM having associated cardiac anomalies were determined. The incidence of cardiac anomalies in two types of ARM was determined. Results: Total number of newborns with ARM admitted for sugery in the period of June 2017 to May 2018 were 182. Out of which 21 cases were having congenital cardiac anomalies (11.53%). ASD is found to be commonest cardiac anomaly comprising 15 (60%). Other cardiac anomalies associated with ARM were VSD 7 (22%), Dextrocardia 2 (8%), Tetrology of Fallot 1 (4%). Newborns with High ARM have higher
incidence of cardiac anomalies when compared to Low ARM (18/7). All cases needed extra perioperative care like antibiotic prophylaxis, avoidance of air entry through ivcanula, avoidance of hypothermia and avoidance of fluid overload. Conclusion: The incidence of associated cardiac anomalies in newborns with ARM were found to 11.53%. High Type of ARM have grater incidence of associated cardiac anomalies. ASD was found to be commonest cardiac anomaly. Our study showed that cardiac evaluation during preoperative evaluation should be a pre­requisite for all cases of ARMs. 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51218.1

Keywords

Ano Rectal Malformation; Congenital Cardiac Anomalies; Preoperative Evaluation.

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