Pulse oximetry screening for clinically unrecognized critical congenital heart disease in the newborns.

AIM

To determine the incidence of clinically unrecognized critical congenital heart disease (CCHD) in the newborns by using pulse oximetric screening.

METHODS

Pulse oximetry was performed on clinically normal newborns at 24-48 hours of age. If screening oxygen saturation (SpO(2)) was below 95%, echocardiography was then performed. Data regarding true and false positives as well as negatives were collected and analyzed.

RESULTS

Pulse-oximetric screening was performed on 1847 clinically normal newborns. Low SpO2 (<95%) was found in three babies two of them had CCHD, including one with transposition of the great vessels, one with complete atrioventricular canal with moderate tricuspid regurgitation (sensitivity: 100%; specificity: 99.8%; positive predictive value: 100%; negative predictive value: 100%; accuracy: 99.8%).

CONCLUSIONS

In addition to routine physical examination in the newborn infants pulse oximetry may improve the early diagnosis CCHD in the newborn. If oxygen saturation in clinically normal newborns is below 95% at 24-48 hours of age, referral to a cardiology unit is suggested.