Liggins Institute, University of Auckland, Auckland, New Zealand.
Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Acta Paediatr. 2020 Jan;109(1):93-99. doi: 10.1111/apa.14946. Epub 2019 Sep 2.
Assess the potential additional benefit from pulse oximetry screening in the early detection of critical congenital heart disease in a country with a well-developed antenatal ultrasound screening programme.
Live-born infants, pregnancy terminations and stillbirths from 20 weeks' gestational age, between 2013 and 2015, with critical cardiac defects defined as primary or secondary targets of pulse oximetry screening were identified. Critical defects were those resulting in the death of a fetus or an infant in the first 28 days after birth, or a defect requiring intervention in the first 28 days.
Two hundred and sixty-eight infants and Fetuses were identified. Antenatal detection rates improved from 69% to 77% over the study period. An associated co-morbidity improved antenatal detection rates. Twenty-seven live-born infants were diagnosed after discharge: 15 aortic arch obstruction (AAO); 10 d-loop transposition of the great arteries (d-TGA), and two total anomalous pulmonary venous drainage (TAPVD). Of these, five with AAO, nine with d-TGA and likely both with TAPVD could potentially have been detected with oximetry screening.
The antenatal detection of critical cardiac anomalies continues to improve in New Zealand. Despite high antenatal detection rates for most lesions, universal postnatal oximetry screening has the potential to improve early detection.
评估在一个产前超声筛查计划发达的国家，脉搏血氧仪筛查在早期发现严重先天性心脏病方面的潜在额外益处。
在 2013 年至 2015 年间，确定了 20 周龄以上的活产婴儿、妊娠终止和死产，这些婴儿存在严重的心脏缺陷，定义为脉搏血氧仪筛查的主要或次要目标。严重缺陷是指导致胎儿或婴儿在出生后 28 天内死亡，或需要在出生后 28 天内干预的缺陷。
共发现 268 例婴儿和胎儿。在研究期间，产前检出率从 69%提高到 77%。相关的合并症提高了产前检出率。27 例活产婴儿在出院后被诊断出：15 例主动脉弓阻塞（AAO）；10 例 d-环大动脉转位（d-TGA），以及两例完全性肺静脉异位引流（TAPVD）。其中，5 例 AAO、9 例 d-TGA 可能都有 TAPVD，有可能通过血氧仪筛查检测到。
在新西兰，严重心脏畸形的产前检出率继续提高。尽管大多数病变的产前检出率很高，但普遍进行产后血氧仪筛查有可能提高早期检出率。
