Keywords : FGH
Al- Anbar Medical Journal,
2015, Volume 12, Issue 1, Pages 83-95
Background: Congenital heart diseases (CHD) comprise the most common group of congenital malformations. Despite recent developments in interventional and surgical techniques, heart disease in children continues to be an important cause of morbidity & mortality .( 1 )
Aim of study : Our aims were to assess the prevalence, age-wise distribution,& clinical spectrum of congenital heart disease , among children in the Fallujah district region in Iraq, during the years 2007 , 2008, 2009 ,2010 & 2011 ,referred to FGH .
Methods: This is a hospital based descriptive study based on retrospective & prospective collecting all cases referred to Fallujah General Hospital (FGH) to identify all patient with CHD ,born between the 1st of January 2007 & December 31, 2011 ,in FGH. 2nd of big referral hospital in Anbar Governorate ,Iraq .Ethical approval was granted by the scientific committee in Fallujah hospital & Anbar medical college .
Live newborns delivered in this hospital are 2414 , 4753 , 5551 , 7011 & 7320 in 2007,2008,2009,2010,& 2011 respectively ( total 27049 ) excluding live newborns that occur outside the FGH . During the study period ,new born & children was done examined & screened for CHD & follow –up for this 5 years.
Clinical examination, 2D echocardiography and color Doppler and sometime cardiac catheterization either in Baghdad or later on in FGH were considered as definitive tools for diagnosis of CHD.
Result :Out of the 533 cases of CHD there were 281 males ( 52.72 % ) & 252 females (47.27 % ) (Fig.1).Out of the 533 cases of CHD there were 59 ( 11.06% ) cases in 2007 ,44 (8.25% ) cases in 2008 , 49 (9.19 %) cases in 2009 ,167 ( 31.33% ) cases in 2010 & 214 ( 40.15% ) cases in 2011 ( Fig .2 ).
The overall prevalence of CHD live births during this 5-year period was 19.7 / 1000 live births. CHD was found to be slightly more common in male than female births (10.38 versus 9.31 per 1000).
ASD was the commonest lesion 193 , followed by , VSD 164 , other (various types of CHDs existing together including rare type of CHDs. ) 52 , PDA 34 , VSD +ASD 31 , PFO 28 , TOF 18 and PS 13 . Fig.( 3 ) .
The rate of CHD was 24.44 per 1000 live birth in 2007 , 9.25 per 1000 live birth in 2008, 8.82 per 1000 live birth in 2009 , 23.81 live birth in 2010 & 29.23 per 1000 live birth in 2011. Figures 4,5.6.7,& 8.
In 2007 & 2008 VSD was the commonest CHD , & PS lowest rate in 2008. Fig ( 4,5).While ASD was the commonest CHD in 2010 & 2011 Fig ( 6,7,& 8 )
Depend on geographical distribution ,the highest rate of CHD was in center of the city 223( 41.83 %) cases ,followed by other ( villages at the city boundaries) 125 (23.45 %) , then eastern region ( Karma ) 97( 18.19%) , Amria 57 ( 10.69%) & lowest rate was in western region Saqlawya 31 ( 5.81%) . Fig. ( 9 )
167 ( 31.33 % ) of the affected newborns had a positive family history of abortion , & 88 ( 16.51 % ) had a maternal history of drugs & X-ray radiation .Fig. ( 11 ).
Conclusion : 1. The present study shows, for the first time, the prevalence and pattern of CHD in Fallujah region in western Iraq.
2. These findings will help establish a database for future studies, which will focus on etiology and ethnic disparity of CHD in the region.
3.The findings can help to establish valuable changes in health policies for the improvement of diagnostic and therapeutic facilities.
4. The present high prevalence rate of CHD in Fallujah need advance research & registration system to apply in Al-Anbar & Iraqi medical offices .
5. The catastrophic successive wars imposed on Iraq undoubtedly have played some role in this problem .
6. The overall pattern of CHD is similar to the finding in other countries