Pulse oximetry as a screening test for congenital heart disease in newborns.

Background: Congenital heart disease (CHD) can be fatal if not diagnosed at the early phases of life. Available diagnostic tools for screening critical CHD are mostly invasive and costly.

Aim: The current study aimed to validate the use of pulse oximetry as a non-invasive and cost-effective tool to screen critical CHD.

Material and methods: This observational study was conducted in a tertiary care teaching institute. A total of 1,082 asymptomatic term neonates (aged 2-24 h) were screened by pulse oximetry and clinical examination for the detection of critical CHD. Neonates with abnormal pulse oximetry and clinical examination findings were subjected to confirm the presence of CHD.

Results: The incidence of critical CHD in asymptomatic newborns was found to be 0.5% (5/1000 live births). Echocardiography confirmed five cases of critical CHD. Pulse oximetry alone could detect 80%, and clinical examination alone could detect 60% of the CHD cases, while combining both methods gave 100% detection rate.

Conclusion: Pulse oximetry is a simple, cost-effective, and reliable tool to diagnose critical CHD. In majority of the newborns who have not undergone fetal echocardiography, the underlying critical CHD can be missed, and in such cases, pulse oximetry screening offers an effective way to minimise the undiagnosed discharge risk.