Abstract

Critical congenital heart diseases (CCHDs)contribute to 6-10% infant deaths. Screening by pulse oximetry (POS) may help in timely diagnosis and management to prevent mortality. Material and Methods- POS was recorded on 376 neonates after 24 hours of birth in one preductal (right upper limb) and one post ductal site (any lower limb). Any value less than 90% or a difference of more than 3 % in two sites was considered positive.It was compared to gold standard 2D ECHO . Results- Total 98.7%(371) neonates had negative POS and remaining 1.3%(n=5) had positive POS. Out of total 376 neonates which were screened, we found 8 cases (2.1%) of non-critical CHD and 4 cases (1.1%) of CCHD as confirmed by 2D-echocardiography, thereby a total of 12 cases (3.2%). On evaluating the efficacy of pulse oximetry as a screening test for evaluation of critical congenital heart disease in comparison to 2D ECHO as the gold standard we found that it had a Sensitivity of 75.00%, Specificity of 99.46%, Positive Predictive Value 60.00% and Negative Predictive Value 99.73% was found. Positive Likelihood Ratio 139.50 (95% CI 31.33 to 621.16). Negative Likelihood Ratio 0.25 (95% CI 0.05 to 1.37) Conclusion- POS is a useful screening tool with high sensitivity and NPV but may miss some CCHD and non-critical CHDs. Universal screening is feasible and may improve outcome of neonates with CCHDs even in resource limited settings

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