Critical Congenital Heart Disease Screening in Neonates in Prapokklao hospital

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Keawalee Thamjamratsri Wasana Prangvatanagul

Abstract

Background: Critical congenital heart disease is congenital heart disease which requires urgent surgery or cardiac catheterization within 1-2 months after birth, otherwise it might cause complications to patients leading to morbidity and mortality. Therefore, the early diagnosis will reduce the morbidity and mortality for these patients. At present, some countries are using a pulse oximeter for the basic screening for critical congenital heart disease in newborns. However, Thailand has not yet implemented its universal use.


Objective: To study the sensitivity, specificity, and accuracy of the pulse oximeter in screening for critical congenital heart disease in order to use the pulse oximeter as a method for basic screening at Prapokklao Hospital’s nursery.


Meterials and method: Cross-sectional study. We included all newborns from April 1, 2017 to April 30, 2018. Screening of oxygen saturation on all newborns was performed. Physical examinations and pulse oximeter screenings were performed on newborns after 24 hours of life but before 48 hours. An echocardiogram was used as a confirmation test in positive screening cases.


Results: There was no critical congenital heart disease from the screening of 3,541 infants in this study. Six cases of critical congenital heart disease were excluded from the study due to presentation of signs and symptoms at age less than 24 hours. The incidence of critical congenital heart disease is 1.69 among 1,000 live births.


Conclusion: The result of this study suggests it is not practical to do the screening in Prapokklao Hospital because there were no cases of critical congenital heart disease found in this screening. This may happen due to the signs and symptoms of critical congenital heart disease being found and diagnosed before 24 hours of age and also due to the small sample size used. To further researchers, we recommend including more infants aged less than 24 hours and increasing the sample size.

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นิพนธ์ต้นฉบับ (Original article)

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