Haydarpasa Numune Med J. Ahead of Print: HNHJ-15986 | DOI: 10.14744/hnhj.2022.15986

The Role of Pulse Oximetry in Congenital Heart Disease Screening

Baran Cengiz Arcagök¹, Ayla Oktay^2
1Department of Pediatrics, Division of Neonatology, School of Medicine, Acibadem University, Istanbul, Turkey
²Department of Pediatric Cardiology, Bakýrköy Acýbadem Hospital, Istanbul, Turkey

INTRODUCTION: Congenital heart defects (CHD) are common congenital malformations and cause mortality and morbidity in the neonatal period. Therefore, the diagnosis of critical CHDs is important. In this study, we aimed to present our critical congenital heart disease screening results with pulse oximetry and to emphasize the importance of screening.
METHODS: All newborns born in our hospital between January 2020 and January 2021 and with a gestational age greater than 34 weeks were included in the study. A total of 1605 newborns were screened with pulse oximetry device.
RESULTS: The median birth weeks of 1605 newborns screened to detect critical congenital heart disease were 38 weeks (34-41 weeks), and their birth weight was 3065 grams (2035-5040 grams). Of the newborns included in the study, 767 (47.8%) were male and 838 (52.2%) were female. While 1591 (99%) of the babies included in the study passed the screening, 14 (1%) remained. False negativity was detected in one of the babies who underwent the screening. Critical CHDs was observed in three (21.4%) of the patients, while false positivity was detected in 11 (78.6%) of the infants who failed the screening. The false positive rate of the screening test in all babies was 0.6%. In our study, the sensitivity of CHD screening with pulse oximetry was 75%, the specificity was 99.3%, the positive predictive value was 21.4%, and the negative predictive value was 99.9%.
DISCUSSION AND CONCLUSION: We thought that since its incidence is not low, it is a life-threatening condition, and early diagnosis and effective interventions are available, CHD screening with pulse oximetry should be performed on all newborns and included in the newborn screening program.

Keywords: Newborn, critically congenital heart disease, pulse oximetry

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Konjenital Kalp Hastalýðý Taramasýnda Nabýz Oksimetre Kullanýmýnýn Tanýdaki Yeri

Baran Cengiz Arcagök¹, Ayla Oktay^2
1Acýbadem Üniversitesi Týp Fakültesi, Çocuk Saðlýðý ve Hastalýklarý Ana Bilim Dalý, Neonatoloji Bilim Dalý, Ýstanbul
²Bakýrköy Acýbadem Hastanesi, Çocuk Kardiyoloji Kliniði, Ýstanbul

GÝRÝÞ ve AMAÇ: Konjenital kalp defektleri (KKH) yaygýn konjenital malformasyonlardan olup yenidoðan döneminde mortalite ve morbiditeye neden olmaktadýr. Bu nedenle kritik KKH’larýn tanýsý önem arz etmektedir. Bu çalýþmada nabýz oksimetre ile yaptýðýmýz kritik konjenital kalp hastalýðý tarama sonuçlarýmýzý sunmayý ve taramanýn önemini vurgulamayý amaçladýk.
YÖNTEM ve GEREÇLER: Ocak 2020 ile Ocak 2021 tarihleri arasýnda hastanemizde doðan ve doðum haftasý 34 gebelik haftasýndan büyük olan tüm yenidoðanlar çalýþmaya dahil edildi. Toplam 1605 yenidoðan nabýz oksimetre cihazý ile tarandý.
BULGULAR: Kritik konjenital kalp hastalýðýný saptamaya yönelik taranan toplam 1605 yenidoðanýn medyan doðum haftalarý 38 hafta (34-41 hafta), doðum aðýrlýklarý ise 3065 gram (2035-5040 gram) idi. Çalýþmaya alýnan yenidoðanlarýn 767’si (%47.8) erkek 838’i (%52.2) ise kadýn idi. Bebeklerin %79,2’si sezaryen ile doðurtuldu. Çalýþmaya alýnan bebeklerden 1591’i (%99) taramadan geçerken 14’ü (%1) kaldý. Taramadan geçen bebeklerin birinde yanlýþ negatiflik saptandý. Taramadan kalan bebeklere yapýlan EKO’da hastalarýn üçünde (%21.4) KKKH görülürken, 11’inde (%78.6) yanlýþ pozitiflik saptandý. Tüm bebeklerde tarama testinin yanlýþ pozitiflik oraný ise %0.6 idi. Çalýþmamýzda nabýz oksimetresi ile KKH taramasýnýn sensitivitesi %75, spesifitesi %99.3, pozitif prediktivite deðeri %21.4 ve negatif prediktivite deðeri %99.9 olarak bulundu.
TARTIÞMA ve SONUÇ: Görülme sýklýðýnýn az olmamasý, hayatý tehdit eden bir durum olmasý ve erken taný ile etkin müdahalelerin bulunmasý nedeniyle nabýz oksimetre ile KKKH taramasý tüm yenidoðanlara yapýlmasýný ve yenidoðan tarama programýna dahil edilmesi gerektiðini düþünmekteyiz.

Anahtar Kelimeler: Yenidoðan, kritik konjenital kalp hastalýðý, nabýz oksimetre

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