Pulse oximetry used in newborn screening for congenital heart diseases

Abstract

Congenital heart diseases are the most frequent congenital malformations in newborns, and the critical ones, which are defined as requiring surgery or catheter-based intervention in the first year of life, count for 25%. Pulse oximetry scre­ening test is a non-invasive test that can detect these mal­for­ma­tions, some of them asymptomatic initially, lowering infatile mor­ta­li­ty and morbidity. The screening procedure is quite sim­ple: the preductal (right hand) and postductal (either foot) oxi­gen saturations are measured, then using the American’s Aca­de­my of Pediatrics algorithm as we describe below, the in­fant can test positive or negative. Targeted malformations are: ductal dependent lesions (transpositions of the great ar­teries, severe aortic stenosis, coarctation of the aorta, in­ter­rupted aortic arch, hipoplastic left heart syndrome, pul­mo­na­ry valve atresia with intact ventriculum septum, severe pulmonary stenosis, severe tetralogy of Fallot), total ano­molous pulmonary venous connection, truncus arteriosus, tri­cu­spid atreisa, Ebstein’s anomaly, single ventricle, double outlet right ventricle. We encourage and support pulse oxi­me­try screening test in all infants before discharge from ma­ter­ni­ty, because it is not an expensive procedure, it can be easily done, reducing the surgical complications due to a late diag­no­sis of these critical malformations.