ASHFORD & ST PETER’S HOSPITALS NHS FOUNDATION TRUST
ASHFORD & ST PETER’S HOSPITALS NHS FOUNDATION TRUST
Pulse Oximetry Screening for Critical Congenital Heart Disease in Asymptomatic Newborns
(As part of Newborn Examination)
Background
• Congenital heart disease (CHD) is the most common type of congenital abnormality, affecting about 7-8 in 1000 babies and accounting for 6-10% of all infant deaths.
• At the more critical end of the spectrum, the incidence of a duct dependent circulation is 1-1.8 babies per 1000 live births
• Antenatal ultrasonography and the newborn clinical examination can miss a significant percentage (up to 30%) of babies born with life threatening congenital cardiac malformations.
• Combining the use of pulse oximetry with clinical examination improves this detection rate to 92%.
Pulse oximetry testing before discharge is an effective, non-invasive, inexpensive screening tool to assist in diagnosing critical congenital heart disease.
• The normal Oxygen saturation in newborn babies is >95% after 10-15 minutes of life.
• Every baby must have its oxygen saturation measured as part of the routine newborn examination prior to hospital discharge.
• Note: A negative screen does not exclude the possibility of congenital heart disease
Pulse Oximetry Algorithm
In all newborn babies, measure O2 saturation pre-ductal (Right hand) and post ductal
(Right or Left Foot) as part of the newborn examination
[pic]
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O2 saturation 90-95% or >3% difference in saturations between the two readings
O2 saturation >95% & d"3% difference in saturations
O2 Saturation less than 90%
Screening is negative.
Complete the process by documenting in baby records
Admit to neonatal unit
Work up for congenital heart dis
O2 saturation >95% & ≤3% difference in saturations
O2 Saturation less than 90%
Screening is negative.
Complete the process by documenting in baby records
Admit to neonatal unit
Work up for congenital heart disease, Pulmonary disease & Sepsis
Inform neonatal consultant
Discuss need for an echocardiogram
( Dr Otunla, Dr Groves or external cardiology referral)
Inform middle grade paediatrician for urgent review
Dr T Otunla-November 2012
Inform middle grade paediatrician
O2 saturation 90-95% or >3% difference in saturations between the two readings
Repeat pulse oximetry in an hour
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