Pulse oximetry as a screening tool for critical congenital heart defects in newborns

J Pak Med Assoc. 2017 Aug;67(8):1220-1223.

Abstract

Objective: To evaluate the effectiveness of pulse oximetry as a screening tool for critical congenital heart defects in newborns.

Methods: This cross-sectional study was conducted at the neonatology department of the Children's Hospital and the Institute of Child Health, Lahore, Pakistan, from January to June 2016, and comprised neonates aged up to 07 days. Babies with a prenatal diagnosis of heart defects and those whose parents refused to give consent were excluded. Oxygen saturation of enrolled patients was measured in right index finger (pre-ductal) and in the left big toe (post-ductal) subsequently. Echocardiography was done on all the enrolled babies to confirm the diagnosis. SPSS 19 was used for data analysis.

Results: Of the 145 babies initially enrolled, 138(95.2%) were included. The overall mean age of the babies was 2.17±1.62 days (range: <24 hours-07 days) whereas the mean birth weight was 2.95±0.47kg (range: <2.5->4kg). Babies with pre- and post-ductal oxygen saturation measurement difference of >3% showed a detection rate of 16(45.7%) for critical congenital heart defects. Sensitivity and specificity of this screening test was calculated to be 76.19% and 83.76%, respectively, while positive and negative predictive values were 45.71% and 95.15%, respectively.

Conclusions: The measurement of pre- and post-ductal oxygen saturation by pulse oximetry was an effective screening tool for the detection of critical congenital heart defects in newborns.

Keywords: Pulse oximetry, Congenital heart defects, Newborn..

MeSH terms

  • Aortic Coarctation / diagnosis
  • Cross-Sectional Studies
  • Echocardiography
  • Female
  • Fingers / blood supply
  • Heart Defects, Congenital / diagnosis*
  • Humans
  • Hypoplastic Left Heart Syndrome / diagnosis
  • Infant, Newborn
  • Male
  • Mass Screening
  • Oximetry / methods*
  • Pakistan
  • Pulmonary Valve Stenosis / diagnosis
  • Sensitivity and Specificity
  • Tetralogy of Fallot / diagnosis
  • Toes / blood supply
  • Transposition of Great Vessels / diagnosis