A Comparative Study of Pulse Oximetry Screening and Clinical Examination in Diagnosis of Congenital Heart Disease

Abstract

Background: Pulse oximetry is a reliable and non-invasive method for measuring oxygen saturation and has a rapid response. During the past several years pulse oximetry has gained wide spread use in the neonatal oxygen monitoring. The present study was done to determine if a pulse oximetry screening combined with clinical examination is superior in the diagnosis of congenital heart disease to clinical examination alone. Subjects and Methods: The term new-born babies born in NARAYANA medical college and Hospital during the study period of 12months (February 2018 to January 2019) had a thorough clinical examination on day 2 of life with emphasis on peripheral pulses, cyanosis, tachypnea, cardiac pulsations and murmurs. Pulse oximetry screening was done within 4hrs of birth and at 48-72hrs of life. Chest X-ray, ECG and Echocardiogram were done for those babies with either abnormal clinical examination or pulse oximetry reading.Clinical examination was done again 2 weeks after discharge. Results: Though routine clinical examination is effective in detection of congenital heart disease in new-borns, combining pulse oximetry and clinical examination after birth had a higher sensitivity for detection of congenital heart diseases in new-borns. Conclusion: Combining clinical examination and pulse oximetry can enhance the clinician’s ability to detect life-threatening congenital heart disease in a timely manner. This issue requires the formulation of national policy that will make screening for CCHD a priority.