Newborn Screening for Critical Congenital Heart Disease Using Pulse Oximetry: A Quality Improvement Project Proposal

Author(s): Khairy G. Gad

Critical congenital heart disease (CCHD) is a leading cause of death in the neonatal period. It accounts for approximately one-third of the cases of mortality due to birth defects [1]. Some infants with CCHD may initially be asymptomatic and look healthy. There is an increasing body of evidence that CCHD could be missed in the first few days, therefore, resulting in increased morbidity and mortality. In the US, the CDC estimates the number of infants where the diagnosis of CCHD is delayed at 1755 cases per annum. Half of those cases would have been diagnosed earlier by Pulse Oximetry [2]. Figures from New Zealand estimate that 1 in 5 babies with undiagnosed CCHD are discharged home [3]. Routine use of pulse oximetry has been recommended recently in the UK by PECSIG to help improve the detection rates of CCHD [4]. In this project, a proposal to adopt routine Pulse Oximetry at DGH level is discussed.

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