Role of Pulse Oximetry and Perfusion Index in Screening for Critical Congenital Heart Disease in Asymptomatic Newborn Babies

Ramesh, S (2012) Role of Pulse Oximetry and Perfusion Index in Screening for Critical Congenital Heart Disease in Asymptomatic Newborn Babies. Masters thesis, Madras Medical College, Chennai.


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INTRODUCTION: Congenital heart disease (CHD) is the commonest group of congenital malformations and affects 7–8/1000 newborns. It contributes to 3% of all infant mortality and 46% of deaths from congenital malformations, with most deaths occurring in the first year of life. One of the major contributors to increased infant mortality and morbidity is clinical deterioration and collapse prior to diagnosis and treatment. Early detection of CHD in the asymptomatic period immediately after birth will reduce clinical deterioration by instigation of appropriate, timely management. Currently infants are screened to detect congenital heart disease by physical examination after birth and another examination at six to eight weeks. However, this method of screening fails to detect up to 50% of CHDs at birth. Several studies have reported the use of pulse oximetry as a screening tool for the detection of CHD. However the detection of left sided obstructive heart diseases remains a problem area with pulse oximetry screening alone. Pulse oximeter sometimes does not detect left heart obstructive lesions which represented 75% of the false negative cases in study by Reide et al.2 With this background, we planned a study to find out the utility of newer generation pulse oximeters with perfusion index in screening for congenital heart diseases. AIM OF THE STUDY: To study the role of pulse oximetry and perfusion index in screening for critical congenital heart disease in asymptomatic newborn babies at 24-72 hrs of life. METHODOLOGY: STUDY DESIGN: Prospective descriptive study. STUDY PLACE: Postnatal and post caesarean wards of Institute of Obstetrics & Gynecology and Hospital for women & children (IOG), Egmore, Chennai. STUDY PERIOD: October 2011- January 2012 (4 months period). INCLUSION CRITERIA: All babies born during the study period and are asymptomatic at 24- 72 hrs of life, being nursed with their mother in the postnatal and post caesarean wards of IOG. EXCLUSION CRITERIA: Asymptomatic babies under evaluation for early onset sepsis. RESULTS: A total of 1,011 babies out of 1,059 eligible babies were screened over a period of four months. Forty eight babies were not screened due to early discharge of mother before 24 hrs of life due to various reasons. There were almost equal number of male and female babies (Male to female ratio= 1.03:1). CONCLUSION: Several studies have proved the role of hemoglobin saturation measurement by pulse oximeter screening in identifying critical Congenital heart diseases. The challenge in identifying left side obstructive heart diseases can be tackled by including perfusion index measurement in the screening protocol. Thus the routine screening of all asymptomatic newborn babies at 24- 72 hours of life with pulse oximeter measurement of hemoglobin saturation and perfusion index may help in early identification of more number babies with critical congenital heart disease.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Pulse Oximetry, Perfusion Index, Critical Congenital Heart Disease, Asymptomatic Newborn Babies.
Subjects: MEDICAL > Neonatology
Depositing User: Subramani R
Date Deposited: 01 Mar 2020 04:35
Last Modified: 01 Mar 2020 04:35

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