Clinical significance of cardiac murmurs among neonates in non-university units of a tertiary care maternity hospital, Colombo, Sri Lanka

Introduction: The complete routine neonatal examination before discharge of the newborn baby is the simplest and earliest way to identify possible heart lesions.

Objective: The aim of this study was to ascertain the clinical significance of precordial murmurs heard on routine neonatal examination

Design: Descriptive, cross sectional study design was applied at routine neonatal examination before discharge of the neonate

Method:  All consecutive 4,804 live born neonates (excluding those dying before neonatal evaluation) at non-university units of the De Soysa Hospital for Women (DSHW) during a ten month period from 15.05.2013 were screened within 24 hours of birth for precordial murmurs and those with audible murmurs were then referred for echocardiography

Results: Prevalence of murmurs and CHD at routine neonatal examination was 16 per 1,000 live births and 15 per 1,000 live births respectively. The most common lesions found in echocardiographic evaluation were atrial septal defect (62%), patent ductus arteriosus (26%), ventricular septal defect (19%) and cyanotic heart with multiple lesions (12%).

Conclusions: At routine neonatal examination, prevalence of murmurs was 1.6% and the prevalence of CHD was 15 per 1,000 live births. If a murmur was heard, there was a 96% chance that the neonate could have CHD.

Sri Lanka Journal of Child Health, 2015; 44(1): 24-30

DOI: http://dx.doi.org/10.4038/sljch.v44i1.7959