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

Shenoy, Krithika Damodar; Rao, Suchetha

doi:10.18203/2349-3291.ijcp20171523

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…Variability in sensitivity and speci city levels across studies may be due to differences in the timing of measurements. Screening in the rst 24 hours of life is less speci c than after 24 hours of birth due to hypoxemia, commonly occurring during the transition from intrauterine to extrauterine life conditions (20,21). In two other studies, screening was implemented within 24 hours with a speci city of 52.4% and 44.22% (22,23).…”

Section: Discussionmentioning

confidence: 99%

Role of pulse oximetry for early detection of critical congenital heart disease among the neonates at hospitals affiliated with shiraz university of medical sciences: A pilot study.

Bahrami,

Rooinpeykar,

Naghshzan

et al. 2024

Preprint

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Background and Objective: Congenital heart disease (CHD) is a structural anomaly of the heart that manifests before birth, and it is one of the most prevalent congenital disabilities. The presentations of CHD are heterogeneous and depend on the defect type and age of the neonate. The physical examination and pulse oximetry provide a high level of accuracy, exhibiting a sensitivity of 92% and a specificity of 98% when used together. Some studies showed that pulse oximetry has an influential role in the screening of CHD. However, there are controversial cutoff levels of oxygen saturation as a Reliable screening. This study aims to evaluate the acceptable cutoff of oxygen saturation based on previous guidelines as the primary goal and the prediction of challenges in the screening program of neonates based on the Newborn Health Program. Method This prospective cohort study from September 2021 to June 2022 on 372 neonates with full inclusion criteria and follow-up. The study focused on newborns admitted to the Neonatal Intensive Care Unit (NICU) at Zainabiyeh Hospital, the tertiary referral NICU center south of Iran. The screening was conducted by qualified medical practitioners using pulse oximetry after the first day of admission. Readings above 95.5% were considered negative, while those below 90% were deemed positive. The results were 90% − 95.5%; re-evaluate after one hour. In the re-evaluation, if the result was above 95.5%, it was considered negative; if it was below 95.5%, it was considered positive. Echocardiography was conducted within 48 hours for all infants with a positive pulse oximetry result. A bedside echocardiogram was performed before discharge for all neonates. Finally, the echocardiography and pulse oximetry results were compared to evaluate the negative and positive predictive value of pulse oximetry results and cutoff. Results Among 372 neonates, 222 (59%) had a normal echocardiogram, and 150 (41%) had an abnormal echocardiogram. Among neonates with abnormal echocardiography, 96% had acyanotic disease, and more than 50% of babies whose oxygen saturation was less than 95.5% had abnormal echocardiography. Pulse oximetry with a cutoff of 95.5% had 100% sensitivity and a specificity of 84–87.5% for the diagnosis of CHD. More than 69% of babies with saturation less than 95.5% in all four limbs had an abnormal echocardiogram. Conclusion Pulse oximetry, as the screening tool, can help early detection of neonates with CHD and is also the cost-benefit method in areas lacking tertiary centers for neonatal echocardiography.

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Section: Discussionmentioning

confidence: 99%

Role of pulse oximetry for early detection of critical congenital heart disease among the neonates at hospitals affiliated with shiraz university of medical sciences: A pilot study.

Bahrami,

Rooinpeykar,

Naghshzan

et al. 2024

Preprint

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“…Shenoy KD et al conclude that pulse oxymetry is helpful in identiifying those missed by the clinician during clinical examination and screen positives to be confirmed by echocardiography. 39 The baby with low oxygen saturation was a full term female child had a normal antenatal scan; delivered by LSCS had a birth weight of 3.6 Kgs. Baby had cyanosis with mean oxygen saturation was 88%, 90% and 92% for right thumb, left thumb and left great toe, respectively.…”

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confidence: 99%

Can pulse oxymetry be used as a routine screening tool in early diagnosis of critical congenital heart diseases in newborns?

Reddy¹,

Devaraj²

2018

Int J Contemp Pediatr

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Background: Unrecognition or delayed diagnosis of severe congenital cardiac diseases (CCD) can lead to cardiac failure, cardiovascular collapse and death. Pulse oximetry can be used as a screening tool for detection of critical CCD (CCCD) in newborns. We conducted this study to correlate pulse oximetry findings in asymptomatic newborns to detect CCCD and coarctation of aorta.Methods: All babies delivered in our hospital were included; after clinical evaluation, pulse oximetry screening was done 12 hours after delivery, taken in three extremities (Right thumb, left thumb and left great toe). If the readings were <95% in any of the limbs, they were further evaluated to detect cardiac defects.Results: Of 800 babies, 54.4% were males and 66.1% were delivered by normal vaginal delivery. Antenatal scan of all were normal. Mean±SD birth weight was 2.92 kg ±.29 ranging 2.14 Kgs-3.80 kgs. Oxygen saturation was >95% in 799 babies, there was no significant clinical findings, and were negative for pulse oxymetry screening; one baby had positive pulse oximetry screening (<95%) with ‘ejection systolic murmur’ over left 2nd and 3rd intercostal space. There was no evidence of cyanosis, oedema or tachypnoea. Pulse oximetry reading was 88% in right thumb, 90% in left thumb and 92% in left great great toe. Echocardiography showed Atrial Septal Defect, Ventricular Septal Defect with Pulmonary Stenosis.Conclusions: Pulse oximetry is a non-invasive, reliable, and useful screening tool for an early detection of CCCD in newborns. The combination of pulse oximetry and clinical judgement is needed.

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Screening of Newborn by Pulse Oximetry at Birth for the Critical Congenital Heart Disease

et al. 2022

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Background: Early diagnosis of congenital heart disease is important for a good clinical outcome. Unrecognized or delayed diagnosis of some severe congenital heart diseases can lead to cardiac failure, cardiovascular collapse, and even death. Pulse oximetry screening (POS) in newborns has been shown to enhance the detection of critical congenital heart disease (CCHD). Clinical evaluation is likely to miss the diagnosis in first few hours of hospital stay after birth due to absence of signs and symptoms of CCHD. In the absence of clinical findings during early neonatal period, the best parameter that can be assessed, is the detection of hypoxemia by pulse oximetry screening. Aims and Objectives: Usefulness of pulse oximetry in newborn for early detection of Critical Congenital Heart Disease (CCHD). Material and Methods: This Prospective Observational Study was conducted on 125 newborn babies in postnatal ward at tertiary care centre for a period of 2 years satisfying the inclusion and exclusion criteria. Evaluation was done between 24 to 48 hours of birth with pulse oximeter. Institutional ethics committee permission was taken prior to study. Results and Conclusion: Total 125 neonates were screened by pulse oximeter, 2 were detected to have positive screen for Congenital Heart Disease (CHD) of which 1 had CCHD confirmed by echocardiography. Study revealed that Pulse Oximetry screening can be an important screening tool in routine neonatal care for early detection of CCHD.

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

Cited by 3 publications

References 9 publications

Role of pulse oximetry for early detection of critical congenital heart disease among the neonates at hospitals affiliated with shiraz university of medical sciences: A pilot study.

Role of pulse oximetry for early detection of critical congenital heart disease among the neonates at hospitals affiliated with shiraz university of medical sciences: A pilot study.

Can pulse oxymetry be used as a routine screening tool in early diagnosis of critical congenital heart diseases in newborns?

Screening of Newborn by Pulse Oximetry at Birth for the Critical Congenital Heart Disease

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