Congenital cardiovascular malformat...

Congenital cardiovascular malformations (CCVMs) come to one's mind in five to 10 infants without of 1,000 live births and are associated with significant morbidity and mortality. Although a four-chamber view enables the detection of many malformations, the take away from of routine fetal echocardiography makes it an impractical screening tool. Preliminary studies hint that pulse oximetry may be an effective screening tool for hypoplastic left heart syndrome coarctation, D transposition of the great arteries, pulmonary atresia with intact ventricular septum tricuspid atresia, total anomalous pulmonary venous turn back and tetralogy of Fallot in asymptomatic newborns. indicateed limitations of oximetry screening are aortic stenosis and coarctation with large ventricular septal lack Koppel and colleagues determined the sensitivity, specificity, predictive value, and accuracy of oscillation oximetry in detecting CCVMs in asymptomatic newborns.

A total of 11281 asymptomatic newborns from the well-infant nurseries of couple hospitals were included in the application of mind Exclusion criteria were any of the following abnormalities fix on examination: cyanosis, tachypnea, grunting, flaring, retraction, whimper active precordium, and diminished measured [i]or[/i] regular beats A single postductal oxygen saturation flat was obtained at the time of metabolic screening in undivided hospital and on discharge in the other hospital. All newborns with 95 percent or les saturation underwent echocardiography.

beating [i]or[/i] throbbing of an artery oximetry detected three cases of CCVM (true positives), and couple cases were diagnosed after discharge (false negatives). The false-negative cases were coarctation and hypoplastic left pulmonary artery with aortopulmonary collaterals, conditions that may not cause desaturation. Four echocardiograms were obtained, detecting three CCVM and common case of delayed transition from fetal to neonatal circulation and self-limited pulmonary hypertension. Analysis showed a sensitivity of 60 percent specificity of 9995 percent positive predictive value of 75 percent negative predictive value of 9998 percent and accuracy of 9997 percent Of note, screening fetal echocardiography was more as a common thing [i]or[/i] matter used in one hospital (revealing nine CCVMs) which explains wherefore rates of detection of CCVM via legumes oximetry were lower in that hospital.

The authors gather that in hospitals with lower rates of fetal echocardiography, measured [i]or[/i] regular beat oximetry is a simple, reliable, and cost-effective screening trial for CCVM in asymptomatic newborns.

Koppel RI, et al. Effectiveness of oscillation oximetry screening for congenital heart disease in asymptomatic newborns. Pediatrics March 2003;111:451-5

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