Value of heart murmurs and transcutaneous oxygen saturation in screening for neonatal congenital heart diseases

Abstract

Objective To compare the importance of heart murmurs and transcutaneous oxygen saturation(SpO2)in screening neonatal congenital heart diseases(CHD), and to explore a reliable and easy-to-use method for the screening of CHD. Methods All infants (16 070 cases) born in Changzhou Maternal and Child Health Hospital from May 1st 2011 to April 30th 2013 were screened of CHD for heart murmurs and SpO2.The screen-positive infants were divided into 3 groups: heart murmurs group, abnormal SpO2 group and mixed group.All screen-positive infants received cardiac color ultrasound to make a definite diagnosis of CHD, so as to compare the values of heart murmurs and SpO2. Results Eight thousand seven hundred and ninety-nine boys and 7 271 girls were screened, in which the ratio was 1.21:1.00.One hundred and eighteen infants were screened positive, including 76 murmurs of which 45 were confirmed as CHD, 28 with abnormal SpO2 of which 18 were confirmed and 14 mixed of which 13 were confirmed, so the confirmation rates were 59.21%, 64.29% and 92.86%, respectively.The diagnostic rate of CHD in mixed group was higher than other 2 groups, which had statistical significance(P=0.045). The top three formation types of CHD were ventricular septal defect (VSD) (29/76 cases, 38.16%), patent ductus arteriosus (PDA) (13/76 cases, 17.11%) and atrial septal defect (ASD) (11/76 cases, 14.48%). Conclusions The combination of heart murmurs and SpO2 was useful in increasing detection and decreasing misdiagnosis of CHD. Key words: Infant, newborn; Congenital heart disease; Heart murmurs; Transcutaneous oxygen saturation; Screening