Is routine preoperative transthoracic echocardiography necessary in newborns with myelomeningocele?

Objective:congenital heart disease (chd) is common in newborns with myelomeningocele. echocardiography before neonatal back closure has been recommended. its utility in the era of prenatal diagnosis is unclear.study design:we reviewed all newborns with myelomeningocele evaluated by preoperative echocardiography at our institution over 11 years.result:seventy-six successive newborns were identified. ninety-one percent were prenatally diagnosed with myelomeningocele. in all, 1% had critical, 12% critical or non-critical and 22% critical, non-critical or possible chd. the single case of critical chd was both prenatally diagnosed and clinically identifiable.conclusion:the prevalence of chd in newborns with myelomeningocele is increased compared with the general population; however, critical disease is uncommon. we propose preoperative echocardiography is unnecessary when the myelomeningocele is prenatally diagnosed, antenatal cardiac screening is complete and normal, and the newborn is clinically well.