@article {Khammari Nystromfetalneonatal-2019-317066, author = {Fatine Khammari Nystrom and Gunnar Petersson and Olof Stephansson and Stefan Johansson and Maria Altman}, title = {Diagnostic values of the femoral pulse palpation test}, elocation-id = {fetalneonatal-2019-317066}, year = {2019}, doi = {10.1136/archdischild-2019-317066}, publisher = {BMJ Publishing Group}, abstract = {Objectives To calculate diagnostic values of the femoral pulse palpation to detect coarctation of the aorta or other left-sided obstructive heart anomalies in newborn infants.Design Population-based cohort study.Setting Stockholm-Gotland County 2008{\textendash}2012.Patients All singleton live-born infants without chromosomal trisomies, at >=35 gestational weeks, followed-up until 1{\textendash}2 years of age.Main outcome measures Diagnostic values and ORs for the femoral pulse test and subsequent diagnosis of coarctation of the aorta or left-sided obstructive heart malformation.Results Among the 118 592 included infants, 432 had weak or absent femoral pulses at the newborn examination. Seventy-eight infants were diagnosed with coarcation of the aorta and 48 with other left-sided obstructive heart malformations. The diagnostic values for the femoral pulse palpation test to detect coarctation of the aorta were: sensitivity: 19.2\%, specificity: 99.6, positive predictive value: 3.5\% and negative predictive value: 99.9\%. For left-sided heart malformations: sensitivity: 8.3\%, specificity: 99.6\%, positive predictive value: 0.9\% and negative predictive value: 100\%. Sensitivity for coarctation of the aorta increased from 16.7\% when examined at \<12 hours of age to 30.0\% at >=96 hours of age.Conclusions The femoral pulse test to detect coarctation of the aorta and left-sided heart malformations has limited sensitivity, whereas specificity is high. As many infants with life-threatening cardiac malformations leave the maternity ward undiagnosed, further efforts are necessary to improve the diagnostic yield of the routine newborn examination.}, issn = {1359-2998}, URL = {https://fn.bmj.com/content/early/2019/10/08/archdischild-2019-317066}, eprint = {https://fn.bmj.com/content/early/2019/10/08/archdischild-2019-317066.full.pdf}, journal = {Archives of Disease in Childhood - Fetal and Neonatal Edition} }