Evers Patrick D, Vernon Margaret M, Schultz Amy H
J Midwifery Womens Health. 2015 Mar-Apr;60(2):206-10. doi: 10.1111/jmwh.12274.
Since 2011, pulse oximetry screening for critical congenital heart disease (CCHD) has been recommended for newborns. Initial implementation guidelines focused on in-hospital births. Recent publications affirm the importance of universal screening, including for out-of-hospital births. No published data describe CCHD screening rates for out-of-hospital births.
Licensed midwives in Washington state were surveyed regarding their current CCHD screening practices, volume of births attended annually, and typical newborn follow-up practices. For those who indicated they were screening, additional information was obtained about equipment used, timing of screening, and rationale for voluntarily initiating screening. For those who indicated that they were not screening, information regarding barriers to implementation was solicited.
Of the 61 midwives in our sample, 98% indicated they were aware of published guidelines recommending universal newborn screening for CCHD utilizing pulse oximetry. Furthermore, 52% indicated that they were screening for CCHD currently. Ten percent stated they do not intend to screen, whereas the remaining respondents indicated that they plan to screen in the future. The primary barriers to screening were the cost of pulse oximetry equipment and inadequate training in screening technique and interpretation.
Although voluntary implementation of CCHD screening by licensed midwives in Washington is increasing, it lags behind the implementation rates reported for in-hospital births.
自2011年以来，已建议对新生儿进行重症先天性心脏病（CCHD）的脉搏血氧饱和度筛查。最初的实施指南侧重于院内分娩。近期的出版物肯定了普遍筛查的重要性，包括对院外分娩的筛查。尚无已发表的数据描述院外分娩的CCHD筛查率。
对华盛顿州有执照的助产士进行了调查，内容涉及他们当前的CCHD筛查实践、每年接生的分娩量以及典型的新生儿随访实践。对于那些表示正在进行筛查的助产士，获取了有关所用设备、筛查时间以及自愿开始筛查的理由的更多信息。对于那些表示未进行筛查的助产士，征求了有关实施障碍的信息。
在我们样本中的61名助产士中，98%表示他们知晓已发表的指南，推荐使用脉搏血氧饱和度仪对新生儿进行CCHD普遍筛查。此外，52%表示他们目前正在进行CCHD筛查。10%表示他们不打算进行筛查，而其余受访者表示他们计划在未来进行筛查。筛查的主要障碍是脉搏血氧饱和度仪设备的成本以及筛查技术和解读方面的培训不足。
尽管华盛顿州有执照的助产士自愿实施CCHD筛查的情况正在增加，但仍落后于院内分娩报告的实施率。
