AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |
Back to Blog
Importantly, there is also evidence to show that pulse oximetry screening improves survival for infants with congenital cardiac disease. The reviewers therefore concluded that current evidence supports the introduction of routine pulse oximetry screening for CCHD. This review showed that six out of 10,000 apparently healthy late preterm and term infants will have CCHD and that pulse oximetry screening can detect five of them. A Cochrane systematic review of 21 studies that included 457,202 participants was published in 2018.9 Pulse oximetry was found to be highly specific (99.9% 95% confidence interval 99.7% to 99.9%) and moderately sensitive (76.3% 95% CI 69.5% to 82.0%) for the detection of critical cardiac disease with a very low false-positive rate (0.14%). The first research in this field emerged in the early 2000s7,8 and now, nearly 20 years later, the value of pulse oximetry as a screening tool for CCHD has been firmly established. This has led to the logical conclusion that pulse oximeters (devices measuring oxygen saturation levels) can be utilised as a screening tool for the detection of CCHD in newborns. Cardiac disease may not cause visible cyanosis, but a degree of hypoxaemia will be present in the majority of infants with severe anomalies. However, even in the most experienced hands the sensitivity of this examination for the detection of cardiac disease is modest.6 In New Zealand this assessment is done on the first day after birth by the lead maternity carer, who is most often a midwife. The newborn physical examination is a screening assessment that can potentially identify infants with an underlying cardiac anomaly. Time is therefore of the essence, as unrecognised cardiac disease can result in sudden cardiovascular compromise and death. This vessel starts to constrict shortly after birth as a result of the rise in blood oxygen content and will generally close within 24–48 hours after birth. The mortality risk for those with severe cardiac anomalies that are unrecognised at the time of birth do, however, remain high as survival often depends on the patency of the ductus arteriosus that enables the mixing of oxygenated blood with deoxygenated blood. ![]() Birth at a centre capable of providing cardiac intervention provides the affected infant with the best chance of survival.5 In the last decade, advances in antenatal screening have been made leading to improvement in the detection of critical congenital heart disease (CCHD) in the fetus.1,2 Furthermore, new developments in the field of interventional cardiology continue to offer those affected by cardiac disease a better chance of survival and an improved quality of life.3,4 Antenatal detection of a severe cardiac anomaly enables physicians and parents to plan and prepare for the birth and to discuss subsequent management pathways if they wish to continue with the pregnancy.
0 Comments
Read More
Leave a Reply. |