Clinical screening for congenital heart disease at birth: A prospective study in a community hospital in Kerala

Vaidyanathan, Balu; Sathish, Gayathri; Mohanan, Sinimol Thoppil; Sundaram, K. R.; Warrier, Karukappilly Krishnan Raghava; Kumar, Raman Krishna

doi:10.1007/s13312-011-0021-1

Cited by 52 publications

(82 citation statements)

References 26 publications

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“…Vaidyanathan, et al [1] arrived at similar conclusions, that we did in our study eight years earlier. A few cases of CHD were missed and in general the modality is limited in its ability to detect CHD [9].…”

supporting

confidence: 92%

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Clinical screening for congenital heart disease at birth: A long way to go

Reich

2011

Indian Pediatr

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supporting

confidence: 92%

“…Like all fields of medicine, these studies have used varied methods rendering any conclusion subject to problems. The first problem is that some papers express the sensitivity of the test as the sensitivity of a combination of both the physical examination and pulse oximetry [1,8,9]. This is superfluous; all newborn infants should have a physical exam.…”

mentioning

confidence: 99%

Clinical screening for congenital heart disease at birth: A long way to go

Reich

2011

Indian Pediatr

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“…In India, frequency of 7.8% was observed for CHDs in a study conducted by Vaidyanathan et al in 2011 on 5487 babies in Kerala (49). High frequency observed in the study strongly emphasized the need for more pilot projects on screening of CHDs.…”

Section: Congenital Heart Diseasesmentioning

confidence: 65%

Current and future perspective of newborn screening: an Indian scenario

Kaur

Thakur

Kataria

et al. 2016

Journal of Pediatric Endocrinology and Metabolism

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Background: Newborn screening comprises a paramount public health program seeking timely detection, diagnosis, and intervention for genetic disorders that may otherwise produce serious clinical consequences. Today newborn screening is part of the health care system of developed countries, whereas in India, newborn screening is still in the toddler stage. Method: We searched PubMed with the keywords newborn screening for metabolic disorders, newborn screening in India, and congenital disorder in neonates, and selected publications that seem appropriate. Results: In India, in spite of the high birth rate and high frequency of metabolic disorders, newborn screening programs are not part of the health care system. At Union Territory, Chandigarh in 2007, newborn screening was initiated and is currently ongoing for three disorders, that is, congenital hypothyroidism, congenital adrenal hyperplasia, and glucose-6-phosphate dehydrogenase (G6PD) deficiency. Prevalence of these disorders is found to be 1:1400 for congenital hypothyroidism, 1:6334 for congenital adrenal hyperplasia, and 1:80 for G6PD deficiency. Conclusion: Mandatory newborn screening for congenital hypothyroidism should be implemented in India, and other disorders can be added in the screening panel on

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“…8 Murmurs are not a feature of conditions such as tricuspid atresia and transposition of great vessels. On the other hand, flow murmurs, due to transitional circulation, may be a prominent feature of trivial tricuspid regurgitation and small ventricular septal defect.…”

Section: Discussionmentioning

confidence: 99%

Positive predictive value of pulse oximetry in the screening of critical congenital heart defects in term neonates

Shenoy

Rao

2017

Int J Contemp Pediatr

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Background: Critical congenital heart defects (CCHD) are associated with poor patient outcome due to delay in diagnosis. Clinical examination alone has low positive predictive value (PPV). Pulse oximetry examination is suggested as supplemental screening tool. Aim of this study was to screen term neonates for CCHD by clinical and pulse oximetry evaluations and estimate their PPV separately and combined.Methods:Cross-sectional study of 278 term neonates weighing ≥2500g excluding those with antenatal diagnosis of congenital heart defects and/or requiring intensive care. Sample size calculated using EpiInfo version 7 taking 20,000 as population size, 7% expected frequency, 5% confidence limits and 99.9% confidence level. Ethical clearance and informed consent obtained. Clinical examination was performed within 24 hours of life followed by pre-ductal and post-ductal oxygen saturation (SpO2) recording, using standardized hand-held probe, between 24-48 hours. Neonates categorized as screen positive or negative based on an adapted algorithm. Screen positives were confirmed by echocardiography. SPSS version 16 was used for statistical analysis.Results: Mean age at clinical examination was 7.72 ± 0.32 hours during which none screened positive. Mean age at SpO2 screening was 31.93 ± 0.32 hours and a single non-syndromic, acyanotic male newborn, weighing 2550g screened positive. He was found to have severe pulmonary outflow obstruction, with ductus-dependent flow on echocardiography. PPV for pulse oximetry screening alone was 100%.Conclusions:Ductus dependent lesions missed on clinical examination may be picked up by pulse oximetry screening. Echocardiography may be used selectively to confirm diagnosis on screen positive.

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Clinical screening for congenital heart disease at birth: A prospective study in a community hospital in Kerala

Cited by 52 publications

References 26 publications

Clinical screening for congenital heart disease at birth: A long way to go

Clinical screening for congenital heart disease at birth: A long way to go

Current and future perspective of newborn screening: an Indian scenario

Positive predictive value of pulse oximetry in the screening of critical congenital heart defects in term neonates

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