Pulse Oximetry Screening in newborn for early detection of Critical Congenital Heart Disease - A review

Abstract

Abstract

An investigation into the challenges and limitations of implementing universal pulse oximetry screening for critical congenital heart disease in asymptomatic newborns

“…(8) This would suggest that for situations where there are staff shortages, routine screening would impose too much of a burden on the staff and additional specially trained assistants would be needed to introduce such screening.…”

“…(7) Life threatening cardiac abnormalities presenting at, or soon after, birth are referred to as critical congenital heart defects (CCHD) with a reported incidence of 2 -3/1 000 live births. (5) Less than 50% of cases of CCHD are recognised when foetal ultrasound is done (8) and approximately 25% of children will Volume 15 Number 1 on prognosis and an increased risk of surgical mortality. Early diagnosis, therefore, is critical.…”

“…It is recommended that a diagnostic echocardiography is performed in all suspected positive cases. (8) In a recent systematic review and meta-analysis it was found that pulse oximetry was highly specific (99.9%) and moderately sensitive (76.5%) when the screen was performed before vs. after 24 hours. It revealed a low false positive rate (0.14%) for the detection of critical congenital heart disease when the screen was performed after 24 hours of birth, thus meeting the standard threshold for universal screening as an adjunct investigation.…”

A 48–year–old female presented with severe neck pain

“…However, it may give false positive result. 25 Before more than a decade, pulse oxymetry was used for detection of critical congenital heart disease with the principle that some degree of clinically undetectable hypoxemia is present in most forms of critical congenital heart disease. Children with arterial oxygen saturation of 80-90% may not have visible cyanosis and such cyanosis is particularly problematic in dark skinned baby.…”