To help detect critical congenital heart disease (CCHD) before signs of a defect manifest, every birthing hospital is required by law (as of July 1, 2015) to use pulse oximetry screening on newborns after 24 hours-old or before discharge if the baby leaves the hospital before 24 hours.
This new addition to the Georgia Department of Public Health (DPH) Newborn Screening Program’s panel closes the gap in care by identifying and providing early treatment for inherited and congenital disorders that otherwise would cause significant morbidity or death.
Signs of CCHD include murmurs and cyanosis, the bluish skin color signifying low oxygen. Early detection is critical as newborns with CCHD often appear normal. In a small percentage of births, a heart defect is missed in prenatal ultrasound or the postnatal physical exam.
Simple and painless, the screening detects potentially life-threatening CCHD before signs of structural heart defects present by measuring the amount of oxygen in the baby’s blood. Screening protocol calls for the newborn pulse oximetry to be taken in the lower extremity at the foot and the right hand. If pulse oximetry numbers are in the abnormal range – signifying a lack of blood flow to the extremities – the baby will undergo additional diagnostic testing before discharge or transferred to a specialized hospital for further evaluation and treatment.
A newborn should never present in your office without CCHD screening results available on hospital discharge papers on the State Electronic Notifiable Disease Surveillance System (SendSS).
- Review screening results
- Notify the DPH if any baby was missed
- Listen to the baby’s heart to ensure nothing was missed
- Provide follow-up care for at-risk infants (if necessary)
- Report results
A negative test result – “pass” – is an oxygen saturation value that is > 95 percent in either extremity and < three percent difference in oxygen saturation between the upper and lower extremity.
Rationale and resources, including referrals for echocardiograms, are available in this online training presentation: http://dph.georgia.gov/sites/dph.georgia.gov/files/MCH/NBS/CCHD_Training_PPT_3_2015.pdf