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NEWBORN SCREENING FOR CRITICAL CONGENITAL HEART DISEASE
What is Critical Congenital Heart Disease (CCHD)?
About 1 in 100 babies is born with congenital heart disease, making heart defects the most common of all birth defects. Congenital heart disease occurs when a baby’s heart or major blood vessels do not form properly. There are many types of heart defects. They range from mild to severe. A “critical” heart defect is one that needs urgent treatment in order to have the best outcome for the baby. Treatment can include medical and surgical procedures.
Why screen for CCHD?
While prenatal ultrasounds may detect some cases of CCHD, not all can be detected before birth. Without screening shortly after birth, babies with CCHD are sometimes sent home without care because they appear healthy. At home, these babies can develop serious health problems and often require emergency care. If CCHD is detected early, however, infants can be treated and lead healthier lives.
When is CCHD screening performed?
•It is performed 24-48 hours after birth or before discharge.
How is screening for CCHD done?
Pulse oximetry is used to screen babies for CCHD. Pulse oximetry is fast, easy and does not hurt. A small sensor is placed on a baby’s right hand and one foot to measure the oxygen level in the blood. Screening for CCHD is done at or after 24 hours after birth. Screening is done while a baby is warm and quiet. If a baby is crying, moving, fussing or cold, then screening will take longer. Screening may also need to be repeated.
What happens if a pulse oximetry reading is low?
Babies with low oxygen levels in their blood may have CCHD. Other conditions like breathing problems or infections may also cause a low blood oxygen level. The doctor will check the baby carefully. An ultrasound of the heart (also called “echocardiogram” and “heart echo”) may be done to look for CCHD.
What do parents need to know if the pulse oximetry reading is normal?
In healthy babies, normal pulse oximetry readings are between 95%-100%, with less than a 4% difference between the reading from the right hand and either foot. A baby with CCHD can have a normal pulse oximetry reading, so a passing result of the pulse oximetry screening does not rule out CCHD. Warning signs that all parents should watch for are: bluish color to the lips or skin, grunting, fast breathing, poor feeding, and poor weight gain.
Think HEART
•HEART RATE: Too low or too high (Normal is 100 to 160 beats per minute)
•ENERGY: Sleepy or falling asleep during feeding
•APPEARANCE: Pale, blue or dusky skin
•RESPIRATION: Breathing too fast or slow (Normal 40-60 breaths per minute)
•TEMPERATURE: Cold to touch, especially feet and hands
If you notice any of these signs in your baby, please contact your baby’s cardiologist.
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