Skip to main content
SpringerLink
Log in

Combining Pulse Oximetry and Clinical Examination in Screening for Congenital Heart Disease

  • Published:
Pediatric Cardiology Aims and scope Submit manuscript

Abstract

The objective of this study was to evaluate combined pulse oximetry and clinical examination as a screening method for congenital heart disease (CHD) in asymptomatic newborns. Asymptomatic newborns were screened for CHD using pulse oximetry and clinical examination before their discharge from the nursery. Oxygen saturation ≥94% was considered normal. Echocardiography was done for newborns with abnormal readings and for those with significant murmurs. Data concerning undetected cases were collected from the pediatric referral hospital. A total of 5211 cases were screened. Echocardiographic evaluations were done based on low pulse oximetry in five cases and on murmur detection in ten others. The sensitivity of the combined method of screening was 77%, whereas it was 31% for oximetry alone and 46% for clinical examination alone. Specificity was ∼100% for all methods. The positive predictive value of the combined tool was 66.7%. We conclude that combining pulse oximetry and clinical examination can enhance the clinician’s ability to detect life-threatening CHD in a timely manner. This screening method should become a part of the discharge plan for every newborn.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. SB Ainsworth JP Wyllie C Wren (1999) ArticleTitlePrevalence and clinical significance of cardiac murmurs in neonates Arch Dis Child Fetal Neonatal Ed 80 F43–45 Occurrence Handle1:STN:280:DyaK1M3lslKlsw%3D%3D Occurrence Handle10325811

    CAS  PubMed  Google Scholar 

  2. RW Byard L Moore (1991) ArticleTitleTotal anomalous pulmonary venous drainage and sudden death in infancy Forens Sci Intl 51 197–202 Occurrence Handle1:STN:280:By2C3M3hsFA%3D

    CAS  Google Scholar 

  3. LJ Elsas (1996) Newborn screening AM Rudolph (Eds) Rudolph’s pediatrics Appleton & Lange Stamford (CT) 282–288

    Google Scholar 

  4. V Grech (2000) ArticleTitleDiagnostic and interventional trends in tetralogy of Fallot and transposition of the great arteries in a population-based study Pediatr Cardiol 21 368–373 Occurrence Handle1:STN:280:DC%2BD3cvgs1Oqtg%3D%3D Occurrence Handle10865015

    CAS  PubMed  Google Scholar 

  5. DMB Hall (Eds) (1996) Health for all children. Report of the Third Joint Working Party on Child Health Surveillance Oxford University Press Oxford

    Google Scholar 

  6. PW Hiatt L Mahony RS Tepper (1992) ArticleTitleOxygen desaturation during sleep in infants and young children with congenital heart disease J Pediatr 121 226–232 Occurrence Handle1:STN:280:By2A2cbhsVU%3D Occurrence Handle1640288

    CAS  PubMed  Google Scholar 

  7. RI Koppel CM Druschel T Carter et al. (2003) ArticleTitleEffectiveness of pulse oximetry screening for congenital heart disease in asymptomatic newborns J Pediatr 142 268–272

    Google Scholar 

  8. KS Kuehl CA Loffredo C Ferencz (1999) ArticleTitleFailure to diagnose congenital heart disease in infancy Pediatrics 103 743–747 Occurrence Handle10.1542/peds.103.4.743 Occurrence Handle1:STN:280:DyaK1M3gsFarsQ%3D%3D Occurrence Handle10103296

    Article  CAS  PubMed  Google Scholar 

  9. RM Payne MC Johnson JW Grant AW Strauss (1995) ArticleTitleToward a molecular understanding of congenital heart disease Circulation 91 494–504 Occurrence Handle1:CAS:528:DyaK2MXjvVKqsLc%3D Occurrence Handle7805255

    CAS  PubMed  Google Scholar 

  10. VK Reddy IR Holzman JF Wedgwood (1999) ArticleTitlePulse oximetry saturations in the first 6 hours of life in normal term infants Clin Pediatr 38 87–92 Occurrence Handle1:STN:280:DyaK1M7lslCksw%3D%3D

    CAS  Google Scholar 

  11. JD Reich S Miller B Brogdon et al. (2003) ArticleTitleThe use of pulse oximetry to detect congenital heart disease Pediatrics 111 451–455

    Google Scholar 

  12. S Richmond G Reay M Abu Harb (2002) ArticleTitleRoutine pulse oximetry in the asymptomatic newborn Arch Dis Child 87 F83–F88 Occurrence Handle1:STN:280:DC%2BD38vjsFyiuw%3D%3D

    CAS  Google Scholar 

  13. A Saxena (2003) ArticleTitleIssues in newborn screening Genet Test 7 131–134 Occurrence Handle10.1089/109065703322146812 Occurrence Handle12885334

    Article  PubMed  Google Scholar 

  14. ED Silove (1994) ArticleTitleAssessment and management of congenital heart in the newborn by the district paediatrician Arch Dis Child 70 F71–F74 Occurrence Handle1:STN:280:ByuC287lvVQ%3D

    CAS  Google Scholar 

  15. S Usen M Weber K Mulholland (1999) ArticleTitleClinical predictors of hypoxaemia in Gambian children with acute lower respiratory tract infection: prospective cohort study BMJ 318 86–91 Occurrence Handle1:STN:280:DyaK1M%2Fps1OgtQ%3D%3D Occurrence Handle9880280

    CAS  PubMed  Google Scholar 

  16. B Varan K Tokel G Yilmaz (1999) ArticleTitleMalnutrition and growth failure in cyanotic and acyanotic congenital heart disease with and without pulmonary hypertension Arch Dis Child 81 49–52 Occurrence Handle1:STN:280:DyaK1Mzos1Kguw%3D%3D Occurrence Handle10373135

    CAS  PubMed  Google Scholar 

  17. C Wren S Richmond L Donaldson (1999) ArticleTitlePresentation of congenital heart disease in infancy: implications for routine examination Arch Dis Child Fetal Neonatal Ed 80 F49–F53 Occurrence Handle1:STN:280:DyaK1M3lslKlsQ%3D%3D Occurrence Handle10325813

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, University of Alexandria, Alexandria, Egypt

    A.F. Bakr

  2. Neonatal Intensive Care Unit, King Abdel-Aziz Specialist Hospital, Taif, P.O. Box10127, Saudi Arabia

    A.F. Bakr

  3. Department of Pediatrics, King Abdulaziz University–Jeddah, Jeddah, P.O. Box6597, Saudi Arabia

    H.S. Habib

Authors
  1. A.F. Bakr
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H.S. Habib
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A.F. Bakr.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bakr, A., Habib, H. Combining Pulse Oximetry and Clinical Examination in Screening for Congenital Heart Disease. Pediatr Cardiol 26, 832–835 (2005). https://doi.org/10.1007/s00246-005-0981-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00246-005-0981-9

Keywords

Search

Navigation