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Research Paper | Pediatrics | India | Volume 12 Issue 4, April 2023
Clinical and Pulse Oximetry Screening to Detect Congenital Heart Diseases in Asymptomatic Newborns
Santanu Ghosh [2] | Deepak Joshi | Sathish Kumar R [2] | Avinash Singh [4]
Abstract: Background: Congenital heart diseases (CHDs) are among one of the commonest congenital malformations encountered in clinical practice and remain an important cause of morbidity and mortality in infants and children. The prevalence of CHD ranges from 8 to 12 per 1000 live births.1, 2With 27 million live births every year, India has a huge burden of children with CHD. Life - threatening CCHD form around 10% - 25% of all CHD in the newborns and one third of these neonates are discharged home without a diagnosis.3Therefore, aim of this study is to assess all newborns in a Tertiary care hospital for congenital heart diseases (CHD) by clinical examination and pulse oximetry. Methods: As part of the screening, all asymptomatic newborns born between February 2021 to July 2022, underwent clinical examination for presence or absence of cyanosis, delayed or absence femoral pulses, cardiac murmur and Spo2 measurement with a pulse oximeter before discharge to home from the postnatal ward. Pulse Oximetry screen: Two separate sites, the right hand (preductal) and either foot (post ductal) were tested consecutively. Clinical screen: Any baby with apparent Cyanosis was confirmed by pulse oximetry and subsequent investigations. Any baby with absent/delayed femoral pulse underwent 4 - limb BP followed by Echocardiography. Any baby with cardiac murmur was evaluated by 2D echocardiography after comprehensive clinical exam. Results: In our study, a total of 350 babies were screened by pulse oximetry and clinical examination. Our study showed that combined screening method identified more number of cases with congenital heart diseases than any single method of screening. It was found to be statistically significant. (P value - 0.0001). Among total 7 cases with abnormal saturation 71.4% showed cardiac murmur and among 343 cases with normal saturation only 0.9% showed cardiac murmur. There is statistically significant association between abnormal saturation and cardiac murmur as p value is <0.0001. Conclusion: Pulse oximetry screening of asymptomatic neonates between 24 and 48 hours of life improved the detection of CCHDs with high specificity and negative predictive value, moderate sensitivity and a reasonably low false positivity rate.
Keywords: critical congenital heart disease, CCHD, congenital heart disease newborns, echocardiogram, cost - effectiveness
Edition: Volume 12 Issue 4, April 2023,
Pages: 1870 - 1874