Document Type : original article
Authors
1 Pediatric and Congenital Cardiology division, Pediatric Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Neonatal Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
3 General Physician, Mashhad University of Medical Sciences, Mashhad, Iran Corresponding Author:
Abstract
Background: Critical congenital heart diseases (CCHDs) are the most common group of congenital malformations in newborns, the mortality and morbidity of which may be prevented by early diagnosis. As a simple and noninvasive technique in detecting hypoxemia, pulse oximetry can help us in the early diagnosis of complex congenital heart diseases. This study aims to provide information for future clinical and health policy decisions for making a Uniform Screening Panel in the early detection of CCHDs in newborns.
Methods: In this study, we determine the prevalence of congenital heart disease in newborns with Oxygen Saturation in the Maternity ward of Imam-Reza Hospital in Mashhad, Iran.
Material and Methods: This is a prospective clinical study which was conducted in the Maternity ward of Imam-Reza hospital between March 2018 and March 2019. We recorded Spo2 of the newborns between 4 to 24 hours after delivery by a trained general practitioner using RS232C/NOVAMETRIX Pulse Oximetry device. The newborn also underwent a comprehensive clinical examination by a neonatologist, and further cardiological evaluation was performed afterward. A pediatric cardiologist performed Echocardiography for the final diagnosis if there was no evidence of other non-cardiac pathologies. Statistical analysis of data was done by SPSS version 24.
Results: Out of a total of 418 newborns screened by a pulse oximetry device, four newborns were screen-positive, and had pulse oximetry tests with Spo2 results. Two of these patients were reported to have complex congenital heart diseases, subsequently. The remaining two newborns with positive screening tests had no congenital heart disease in echocardiography evaluation.
Conclusion: This study revealed that a pulse oximetry screening test could be beneficial for detecting many of the newborns with CCHDs before hospital discharge. However, further research studies with larger sample sizes are necessary for a definitive result.
Keywords
- Diller CL, Kelleman MS, Kupke KG, Quary SC, Kochilas LK, Oster ME. A modified algorithm for critical congenital heart disease screening using pulse oximetry. Pediatrics. 2018; 141(5).
- Peterson C, Ailes E, Riehle-Colarusso T, Oster ME, Olney RS, Cassell CH, et al. Late detection of critical congenital heart disease among US infants: estimation of the potential impact of proposed universal screening using pulse oximetry. JAMA pediatrics. 2014; 168(4):361-70.
- Uygur O, Koroglu OA, Levent E, Tosyali M, Akisu M, Yalaz M, et al. The value of peripheral perfusion index measurements for early detection of critical cardiac defects. Pediatrics & Neonatology. 2019; 60(1):68-73.
- Reich J, Connolly B, Bradley G, Littman S, Koeppel W, Lewycky P, et al. Reliability of a single pulse oximetry reading as a screening test for congenital heart disease in otherwise asymptomatic newborn infants: the importance of human factors. Pediatric cardiology. 2008; 29(2):371-6.
- Willim HA, Supit AI. Critical Congenital Heart Disease in Newborn: Early Detection, Diagnosis, and Management. Bioscientia Medicina: Journal of Biomedicine and Translational Research. 2021; 5(1):107-16.
- Riede FT, Wörner C, Dähnert I, Möckel A, Kostelka M, Schneider P. Effectiveness of neonatal pulse oximetry screening for detection of critical congenital heart disease in daily clinical routine—results from a prospective multicenter study. European journal of pediatrics. 2010; 169(8):975-81.
- Hamilçıkan Ş, Can E. Critical congenital heart disease screening with a pulse oximetry in neonates. Journal of perinatal medicine. 2018; 46(2):203-7.
- Mawson IE, Babu PL, Simpson JM, Fox GF. Pulse oximetry findings in newborns with antenatally diagnosed congenital heart disease. European journal of pediatrics. 2018; 177(5):683-9.
- Granelli Ad-W, Wennergren M, Sandberg K, Mellander M, Bejlum C, Inganäs L, et al. Impact of pulse oximetry screening on the detection of duct dependent congenital heart disease: a Swedish prospective screening study in 39 821 newborns. Bmj. 2009; 338.
- Kumar P. Universal pulse oximetry screening for early detection of critical congenital heart disease. Clinical Medicine Insights: Pediatrics. 2016; 10: CMPed. S33086.
- Turska A, Borszewska MK, Błaż W, Kawalec W, Żuk M. Early screening for critical congenital heart defects in asymptomatic newborns in Mazovia province: experience of the POLKARD pulse oximetry programme 2006–2008 in Poland. Kardiologia Polska (Polish Heart Journal). 2012; 70(4):376-82.
- Narayen IC, Blom NA, Bourgonje MS, Haak MC, Smit M, Posthumus F, et al. Pulse oximetry screening for critical congenital heart disease after home birth and early discharge. The Journal of pediatrics. 2016; 170:188-92. e1.
- Hoke T, Donohue P, Bawa P, Mitchell R, Pathak A, Rowe P, et al. Oxygen saturation as a screening test for critical congenital heart disease: a preliminary study. Pediatric cardiology. 2002; 23(4):403-9.
- Koppel RI, Druschel CM, Carter T, Goldberg BE, Mehta PN, Talwar R, et al. Effectiveness of pulse oximetry screening for congenital heart disease in asymptomatic newborns. Pediatrics. 2003; 111(3):451-5.
- Thangaratinam S, Daniels J, Ewer AK, Zamora J, Khan KS. Accuracy of pulse oximetry in screening for congenital heart disease in asymptomatic newborns: a systematic review. Archives of Disease in Childhood-Fetal and Neonatal Edition. 2007; 92(3):F176-F80.
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