Introduction: Critical congenital heart disease (CCHD) in newborns has a worldwide prevalence of 1-2 per 1000 live births and often remain asymptomatic pre-discharge, leading to significant morbidity and mortality. Screening depends on physical examination (PE) and pulse oximetry (PO) which is proposed as a novel method. Objective: Evaluate efficacy and suitability of PO as a screening strategy of CCHD compared to PE in the Sri Lankan setup. Method: A prospective study was conducted in 5435 asymptomatic newborns, period of amenorrhoea (POA) ≥34weeks, aged ≥24 hours, in Castle Street Hospital for Women, Colombo. Preductal and post-ductal oxygen saturation (SpO2) measurements in right hand (RH) and right foot (RF) along with PE were performed. Babies without SpO2 thresholds of ≥95% in RH and RF and ≤3% difference between RH and RF or with abnormal PE, underwent 2D echocardiogram. Results: Detection rate of CCHD by PO and PE were 91% and 82% respectively. Addition of PO screening to PE detected 02 missed cases. PO and PE sensitivities were 90.9% and 81.8% (p=0.54) and 100% in combination (p=0.8), and specificities were 99.9% and 98.2% respectively (p=0.37) and 98.1% in combination. Positive predictive value _________________________________________

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Introduction: Congenital heart defect (CHD) is the commonest congenital anomaly, accounting for 28% of major malformations. Birth prevalence of CHDs ranges from 5-10 per 1000 live births.Objectives: To assess the birth prevalence of CHDs and describe the structural variations, severity and prevalence among different birth weights.Method: This is a hospital based retrospective study over a period of 5 1 /2 years from 01/01/2015 to 30/06/2020. All live births at the Sri Jayewardenepura General Hospital (SJGH) during the study period were included in the study. Data were extracted from the congenital birth defects registry, maintained by the medical staff of the neonatal unit of SJGH since 2015. Data were entered into Excel sheet and analysed using SPSS statistical software version 22.Results: A total of 19,729 babies was born during the study period. Prevalence was 13.64 per 1000 live births. Prevalence of mild, moderate and severe cases were 8/1000, 2.73/1000 and 2.69/1000 live births respectively. Prevalence of CHDs in low birth weight (LBW) and normal birth weight babies were 42.54 and 8.9 per 1000 live births respectively. Atrial septal defect (ASD) was the most prevalent heart defect followed by patent ductus arteriosus (PDA) and ventricular septal defect (VSD). Tetralogy of Fallot (TOF) was the most prevalent critical congenital heart defect (CCHD). Right ventricular tract obstructive lesions were more prevalent than left ventricular tract obstructive lesions. __________________________________________ 1