Role of pulse oximetry screening for detection of critical congenital heart disease in asymptomatic term and near-term newborn

Introduction: Pulse oximetry test is an inexpensive, non-invasive, painless test that can be life-saving, particularly in the diagnosis of right to left shunt and critical congenital heart disease. Objective: To determine the role of pulse oximetry screening for early diagnosis of CCHD in asymptomatic term and near-term newborn. Methodology: This cross-sectional study was carried out in ICMH, Dhaka. Total 1057 healthy term and near-term newborn, age between 24 and 72hourswere screened. If the oxygen saturation measurement<90% in right hand/ foot, and/or oxygen saturation measurement<95% in both extremities on three consecutive measurement, and/or there is a >3% absolute difference in oxygen saturation between the right hand and foot on three consecutive measurement were considered as pulse oximetry screening positive. An echocardiography was done in all neonates. Statistical analysis was done by using SPSS-23 software. Results: Among 1057 neonate 43(4.06%) had CHD. Among these 43 neonates 31(72.09%) had screening positive and 12(27.90%) had screening negative. The validity of CHD for screening positive cases was correlated by calculating sensitivity, which was 72.1%, specificity 99.9%, accuracy 98.8%, PPV  96.9% and NPV  98.8%. The validity of critical CHD for screening positive was correlated by calculating sensitivity that was 90.9%, specificity 99.8%, accuracy  99.5%, PPV  93.8% and NPV 99.7%. Conclusion: The validity of CHD for screening positive is higher in specificity and show high accuracy.   The validity of critical CHD for screening positive reveal high sensitivity, specificity and high accuracy.