Pulse Oximetry Screening For Critical Congenital Heart Defects In Asymptomatic Newborn

Abstract

BACKGROUND AND OBJECTIVE Congenital heart disease (CHD) is a leading cause of infant mortality, accounting for more deaths than any other type of malformation.1 The incidence of CHD varies between 4-10/1000 live births in India.2 About 1 in every 4 babies born with a heart defect has a critical congenital heart defect (critical CHD, also known as critical congenital heart disease). This study was designed to screen for CCHD using pulse oximeter in the asymptomatic newborns admitted in the post natal ward and Correlate results with ECHO finding in pulse oximetry positive cases. METHODS In Asymptomatic new borns measurement of oxygen saturations using pulse oximeter on the Right hand and foot was carried out after 24hrs of birth . Saturations above 95% was regarded as having negative screen .Those with saturation below 90% were subjected to Echocardiography. Patients with saturations between 90 and 95 % were subjected to a second pulse oximetry screen 6-12 hrs later. Screening was done after 24 hrs of birth. Detailed clinical examination was done in all newborns after pulse oximetry. Any positive findings in CVS was noted. Those Newborns who have negative screen, were asked to report if any symptoms develop. RESULTS Out of total 400 neonates were screened and 7 cases of hypoxemia were identified.They were subjected to ECHO and4 had diagnosed to have critical xi congenital heart disease (TGA,TAPVC,DORV) and two cases had ASD and one was normal.Negative screen did not report back with any symptoms. The incidence of CCHD in the present study was found to be 1%. The predictive value of a positive test of Pulse oximetry was found to be 57.1% in our study. CONCLUSIONS Pulse Oximetry is a cheap and simple test to screen for CCHD before they become symptomatic.