![]() ![]() This detection rate was similar to rates found in large studies in the USA and UK. In Alberta, from 2007 to 2010, only 50% of newborns with CHD requiring surgery before 1 year of age were diagnosed prenatally. Ĭurrent screening with prenatal ultrasound is limited by low sensitivity. A one-time survey from the Canadian Paediatric Surveillance Program (CPSP) showed that 36% of responders had been involved in a late-presenting CCHD case, of which 52% of the responders recalled the case requiring resuscitation. In a study from Sweden, deaths from unrecognized CCHD occurred at a rate of 4.6/100,000 live births. One US study estimates that 30% of CCHDs are diagnosed more than 3 days after birth, while a study from northern England reports 25% of CCHDs are diagnosed following discharge from hospital. ![]() WHY DO WE NEED TO DO MORE?Įarly diagnosis remains crucial for CCHD because delay increases morbidity, mortality and disability. Approximately one-quarter of these newborns have CCHD, defined as more severe and often duct-dependant lesions that require intervention early in life for optimal outcome ( Box 1). WHAT IS CRITICAL CONGENITAL HEART DISEASE?Ĭongenital heart disease (CHD) is the most common congenital malformation, with a prevalence of 12/1000 live births in Canada. Throughout this practice point, the term ‘newborn’ includes both term and late preterm infants (born between 34 0/7 weeks and 36 6/7 weeks gestational age) being cared for in locations outside the neonatal intensive care unit (NICU). This practice point presents highlights and recommendations from a recently published, Canadian Paediatric Society-endorsed position statement from the Canadian Cardiovascular Society and Canadian Pediatric Cardiology Association. While many programs around the world have recommended and adopted screening, it is not yet standard practice in Canada. Pulse oximetry screening (POS) in newborns has been shown to enhance the detection of critical congenital heart disease (CCHD) –. When a cardiac diagnosis cannot be excluded, referral to a paediatric cardiologist for consultation and echocardiogram is advised. Newborns with abnormal results should undergo a thorough evaluation by the most responsible health care provider. Screening should be performed between 24 hours and 36 hours postbirth, using the infant’s right hand and either foot to minimize false-positive results. Optimal screening for critical congenital heart disease should include prenatal ultrasound, physical examination and pulse oximetry screening. The present practice point highlights essential details and recommendations for screening, which research has shown to be highly specific, with low false-positive rates. However, this test has yet to be adopted as routine practice in Canada. Pulse oximetry screening is safe, noninvasive, easy to perform and proven to enhance detection of critical congenital heart disease in newborns. Paediatrics & Child Health, 22(8):494–498 Abstract Michael Narvey, Kenny Wong, Anne Fournier Fetus and Newborn Committee ![]()
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