Title: Screening Newborn babies for Congenital Heart Disease: Prospective Observational Study

Authors: Theranirajan, Venkatesan Kannan, Swami, Karthick AR, Elavarasi

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i10.192

Abstract

Background: Screening for congenital heart disease is important as it accounts for 20% of the life threatening conditions resulting in Neonatal deaths. This screening programme is implemented in Government Vellore Medical College and Hospital aiming at reducing the morbidity and mortality of critical congenital heart disease.

Objective: Screening the asymptomatic newborns for congenital heart disease using saturation monitoring.

Design: Prospective observational study

Study period: Jan’2016-Dec’2016

Setting: Post Natal wards in a tertiary care Hospital, Government Vellore Medical College and Hospital, Vellore.

Study Subjects: Asymptomatic term newborn babies born in hospital after 48 hours of life.

Result: Of the 11268 babies delivered, 2450 babies were included in the study. Among these babies, 9 had low saturation with mean SpO2 of 78 and standard deviation of 12.7. Out of 9 neonates with low SpO2, 5 were confirmed to have CHD and other 4 found to have non CHD causes (3 PPHN and 1 sepsis). Among the 11268 deliveries, 43 babies had symptomatic CHD with incidence of 1 in 262 babies born.

Conclusion: Screening the New born with saturation Monitor detected 4 critical and 1 non-critical congenital heart diseases out of 2450 with SpO2 Monitor. These babies with critical congenital heart disease underwent corrective cardiac surgeries at tertiary care centre with help of CMCHIS and private partnership. Early Intervention prevented early death as well complications secondary to CHD. Screening for congenital heart disease should be included as a part of newborn assessment and early identification influences outcome.

Keywords: Saturation monitoring, critical congenital heart disease.

References

  1. Mahle WT, Newburger JW, Matherne GP, Smith FC, Hoke TR, Koppel R, et al. Role of Pulse Oximetry in Examining Newborns for Congenital Heart Disease. Circulation. 2009 Aug 4;120(5):447–58.
  2. Koppel RI, Druschel CM, Carter T, Goldberg BE, Mehta PN, Talwar R, et al. Effectiveness of Pulse Oximetry Screening for Congenital Heart Disease in Asymptomatic Newborns. Pediatrics. 2003 Mar 1;111(3):451–5.
  3. Ewer AK, Middleton LJ, Furmston AT, Bhoyar A, Daniels JP, Thangaratinam S, et al. Pulse oximetry screening for congenital heart defects in newborn infants (PulseOx): a test accuracy study. The Lancet. 2011 Aug 27;378(9793):785–94.
  4. Riede FT, Wörner C, Dähnert I, Möckel A, Kostelka M, Schneider P. Effectiveness of neonatal pulse oximetry screening for detection of critical congenital heart disease in daily clinical routine—results from a prospective multicenter study. Eur J Pediatr. 2010 Aug 1;169(8):975–81.
  5. Thangaratinam S, Brown K, Zamora J, Khan KS, Ewer AK. Pulse oximetry screening for critical congenital heart defects in asymptomatic newborn babies: a systematic review and meta-analysis. The Lancet. 2012 Jun 30;379(9835):2459–64.
  6. Granelli A de-Wahl, Wennergren M, Sandberg K, Mellander M, Bejlum C, Inganäs L, et al. Impact of pulse oximetry screening on the detection of duct dependent congenital heart disease: a Swedish prospective screening study in 39 821 newborns. BMJ. 2009 Jan 9;338:a3037.

Corresponding Author

Dr Theranirajan

Professor of Pediatrics, Govt. Vellore Medical College, Vellore

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