EFFECEVTIVNESS OF PULSE OXIMETRY SCREENING IN EARLY DETECTION OF CRITICAL CONGENITAL HEART DISEASE AMONG TERM NEWBORN BABY

Abstract

Abstract Background: Up to 10% of all baby deaths are caused by congenital heart disease (CHD) . However, it is possible that some defects may not be detected until delivery or even after the baby has been discharged. . Pulse oximetry (POX) screening is a new cost-effective revolution added to newborn screening to enhance and increase the detection rate of CCHD so help in early diagnosis and early initiating of treatment and this decrease the morbidity and mortality. This study aimed to find out whether POX is a reliable and acceptable screening method for the early identification of CCHD among asymptomatic newborns aged up to 48 hours of life. Methods: observational prospective cohort study, conducted over June- July 2024,convenience sample of 250 newborn included from three hospitals in Nablus city –Palestine, pre-ductal saturation and post-ductal saturation taken from newborn aged up to 48 hour of life ,after routine physical examination . Positive POX screening and positive physical examination finding (murmur) undergoing echocardiogram. Pilot study conducted at 25 baby before starting data collection to assess questionnaire validity and appropriateness measured the real time required for completion, highlighted phrasing deficiencies. Results: Out of 250 case five babies detected with abnormal result, 1 had positive POX screening results confirmed later as CCHD case (HLHS) and 4 babies had positive physical examination finding (murmur) only one case diagnosed by echocardiogram as small PDA with mild pulmonary stenosis. the prevalence of CCHD among newborns is 0.4 % and the prevalence of Non-CCHD is 2.4 %, whereas the sensitivity and specificity PO screening test were 100% for each respectively. Conclusion: pulse oximetry screening is cost effective, painless and save method can help in early detection of CCHD and initiate early treatment, in addition to newborns physical examination ,POX screening should be done to all newborn before discharge at private and governmental hospitals and delivery care centers also train medical staff at neonatal intensive care unit and maternal wards, including midwives and nurses, on how to perform screening, so that it can be performed on all babies prior to discharge.