Cubells Elena, Torres Begoña, Nuñez-Ramiro Antonio, Sánchez-Luna Manuel, Izquierdo Isabel, Vento Máximo
Division of Neonatology, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain.
Instituto de Investigación Sanitaria La Fe, 46026 Valencia, Spain.
Int J Neonatal Screen. 2018 Jan 5;4(1):3. doi: 10.3390/ijns4010003. eCollection 2018 Mar.
Despite the progress in the fetal echocardiographic detection of congenital critical heart defects and neonatal physical examination, a significant number of newborn infants are discharged and readmitted to the hospital in severe condition due to cardiac failure or collapse. The aim of this study was to assess the incidence of undetected critical congenital heart disease (CCHD) by a pulse oximetry-screening program in the maternity wards of hospitals with Perinatal Services in a specific geographic area. This is a prospective observational study performed in in the health area corresponding to the city of Valencia. Eligible infants were consecutively admitted newborn infants in the maternities of the participating hospitals with negative fetal echocardiography after normal physical examination in the delivery room. All patients were screened following a specific pulse oximetry protocol before discharge. A total of 8856 newborn infants were screened. A total of three babies presented with severe congenital cardiac malformation and two babies presented with early onset sepsis. Sensitivity was 100% and specificity was 99.97%, with a positive predictive value of 60% and negative predictive value of 100%. Pulse oximetry screening programs in the early neonatal period constitute a valuable tool to avoid inadvertent hospital discharge of severe cardiac malformations and the subsequent life-threatening complications derived.
尽管胎儿超声心动图对先天性严重心脏缺陷的检测以及新生儿体格检查取得了进展，但仍有相当数量的新生儿因心力衰竭或心脏骤停出院后又被紧急送回医院，病情严重。本研究的目的是评估在特定地理区域内设有围产期服务的医院产科病房中，通过脉搏血氧饱和度筛查程序未检测出的严重先天性心脏病（CCHD）的发生率。这是一项在与瓦伦西亚市相对应的健康区域进行的前瞻性观察性研究。符合条件的婴儿是在产房经过正常体格检查且胎儿超声心动图检查结果为阴性后，连续入住参与研究医院产科的新生儿。所有患者在出院前均按照特定的脉搏血氧饱和度检测方案进行筛查。总共筛查了8856名新生儿。共有3名婴儿患有严重先天性心脏畸形，2名婴儿患有早发性败血症。敏感性为100%，特异性为99.97%，阳性预测值为60%，阴性预测值为100%。新生儿早期的脉搏血氧饱和度筛查程序是一种有价值的工具，可避免严重心脏畸形婴儿被意外出院以及由此引发的危及生命的并发症。
