Pulse Oximetry Screening of Newborn for Critical Congenital Heart Disease in Developing Countries

Lakra Ms, Taksande A, Lakra A, Ahlawat Ks
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Abstract

Congenital heart disease is the most commonly diagnosed congenital anomaly in the neonatal period. It has been proved by studies that neonatal examination and murmur are not reliable signs in newborns and we may miss underlying heart problems. If routine neonatal screening is not undertaken, there is a 25% possibility of missing congenital heart disease and 40% of these cases may present with shock and circulatory collapse in the hospital in the subsequent days. As the delay in diagnosis may increase the neonatal mortality so all newborn babies must be screened before discharge. All babies who failed pulse oximetry threshold of less than 95% must be screened by preductal and post ductal pulse oximetry as underlying hypoxaemia may be missed clinically. Many studies have proven that if a newborn is screened within the first week, the chances of missing cardiac problems drop dramatically, to less than 30%. Seeing the burden and severity of this illness, it is recommended by the American Academy of Pediatrics and the American Heart Association that neonatal screening should be done in all developed, affordable countries. This article aimed at making physicians and policymakers in developing countries aware of the need to detect critical heart disease at the right time and addresses to implement policies so that intervention can be done timely to prevent neonatal mortality.
发展中国家新生儿重症先天性心脏病的脉搏氧饱和度筛查
先天性心脏病是新生儿期最常见的先天性异常。研究证明,新生儿检查和杂音不是新生儿的可靠迹象,我们可能会遗漏潜在的心脏问题。如果不进行常规新生儿筛查,有25%的可能性遗漏先天性心脏病,其中40%的病例可能在随后的几天内在医院出现休克和循环衰竭。由于诊断延误可能增加新生儿死亡率,因此所有新生儿必须在出院前进行筛查。脉搏血氧仪阈值小于95%的婴儿必须通过导管前和导管后脉搏血氧仪进行筛查,因为潜在的低氧血症可能在临床上被遗漏。许多研究已经证明,如果新生儿在第一周内接受筛查,遗漏心脏问题的几率会大幅下降,降至30%以下。鉴于这种疾病的负担和严重程度,美国儿科学会和美国心脏协会建议在所有发达、负担得起的国家进行新生儿筛查。本文旨在使发展中国家的医生和政策制定者意识到在正确的时间检测重症心脏病的必要性,并解决实施政策的问题,以便及时进行干预以预防新生儿死亡。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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