C ongenital heart disease (CHD) is the most common group of congenital malformations and affects 7-8/1000 newborns [1]. Approximately one-quarter of these children would have critical CHD (CrCHD), which, by definition, requires surgery or catheter intervention in the 1 st year of life [2,3]. Timely diagnosis of CrCHD is challenging but critical. Children with such life-threatening defects may not initially show symptoms or they may be vague and the condition is not detected on routine clinical examination in the majority of cases [4]. Delayed or missed diagnosis leads to significant morbidity and mortality. There is no effective screening tool for the detection of CrCHDs condition. Pre-natal ultrasound, performed by those with specific training in detecting CHD, can identify a variety of CrCHD lesions; however, numerous studies have reported that even when fetal ultrasound is routinely performed during pregnancy, fewer than 50% of cases of CrCHD are identified [5]. Echocardiography (echo) is the gold standard for the detection of CHD. However, it is impractical to use it as a screening tool in all newborns. Pulse oximetry can pick up the desaturation of blood objectively. It has been used to screen for CHD in newborns. It is a non-invasive procedure and has shown high specificity in the detection of CHD [1,6]. The objective of the study was to assess the usefulness of pulse oximetry as a screening tool for early detection of CrCHD in otherwise asymptomatic newborns. MATERIALS AND METHODS This study was a hospital-based prospective observational study carried out at the Department of Paediatrics at a Tertiary Hospital of Southern India over a period of 12 months from January 2016 to December 2016. Institutional ethical committee clearance was obtained. A total of 1000 asymptomatic newborns of >35 weeks of gestation were enrolled in the study. All newborns <35 weeks of gestation, all symptomatic newborns, and antenatally detected CHDs were excluded from the study. A pre-designed and pretested pro forma was used to collect information. Informed consent was obtained from parents or guardians for the enrolment of their babies in the study. Data related to antenatal risk factors, antenatal scan, gestational age, sex, birth weight were noted and detailed newborn examination was done and documented. All the babies were clinically examined between 24 and 72 h of life with an emphasis on the peripheral pulse, cyanosis, tachypnea, cardiac pulsations, murmur, and external markers of CHDs (flat ABSTRACT Background: Timely diagnosis of critical congenital heart disease (CrCHD) is challenging but critical. Although echocardiography is the gold standard for diagnosis of CrCHD, it cannot be used as a screening tool. Pulse oximetry is a non-invasive, cost-effective screening tool, which can be used to detect CrCHDs in newborns. Objective: The main objective of the study was to assess the usefulness of pulse oximetry as a screening tool for early detection of CrCHD in otherwise asymptomatic newborns. Materials and Methods: This stu...
