The safety of postnatal transport of newborns prenatally diagnosed with duct-dependent congenital heart disease

Objective: Critical congenital heart disease is increasingly recognized prenatally. Following the diagnosis, families are advised to deliver in a facility where neonatal cardiac interventions are available. We studied the safety of transport of neonates who had been prenatally diagnosed with duct-dependent congenital heart lesions. Methods: We performed a retrospective chart review of all fetuses diagnosed with duct-dependent congenital heart disease in our fetal program between 2007 and 2011. Demographic data, dose of prostaglandin infusion, respiratory status, blood gas data, as well as complications of the transport were collected. Results: Twenty-nine neonates qualified for inclusion in the study. Ten were intubated (7 electively) prior to the transport. One of these required intervention for desaturation during the transport. One of the 19 unintubated patients required emergent intubation during the transport. Thus, the overall rate of incidents was 6.9%. All 4 patients who developed apnea requiring intubation did so within 1 h of starting prostaglandin. Conclusions: Elective postnatal transport of neonates prenatally diagnosed with duct-dependent congenital heart lesions is safe. Prophylactic intubation of these infants may not be necessary. It would be advantageous to schedule the elective transport an hour after starting prostaglandin or later.