Health Team

Hospitals could begin screening for heart defects in newborns

Posted August 22, 2011

Baby Medical
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— A federal advisory panel led by a Duke University doctor is recommending that more hospitals use a simple, painless test to screen for congenital heart disease in newborns. 

A pulse oximetry is non-invasive and inexpensive and can detect a heart defect even before symptoms are present. To administer the screening, a doctor tapes a sensor to a newborn's foot that measures the amount of oxygen in the blood.

"It's particularly important to identify these babies with critical congenital heart defects because, if we don't, they can go home from the nursery and very rapidly die," said Dr. Alex Kemper, a pediatrician and professor at Duke University, who authored the recommendation.

One in 120 infants are born each year with congenital heart disease, and 25 percent of those die from it. North Carolina health officials say they are aware of the federal recommendation and are interested in talking with physicians about the test.

Newborn heart defect Test detects heart defects in newborns

The state's hospitals are already required to screen for more than 30 conditions, including hearing disorders, cystic fibrosis and sickle cell disease.

Jodi Koravos, whose 2-month-old son Alex was born with a heart defect, supports the testing. She remembers finding out that something was seriously wrong with her newborn baby.

"One of the nurses was getting ready to bring him back to our room, and she noticed his fingernails were turning blue," she said. "In that one instant, everything changed."

Alex was rushed off for emergency heart surgery, and although he still has two surgeries ahead of him, Koravos said he's recovering well.

"If it weren't for the giant scar in the middle of his chest, you wouldn't know there was a problem with him," she said.


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  • callme4avon Aug 26, 2011

    I'm a grandmother to 3 grandsons, when #2 was born perfect baby.
    The neonatologist said he look great. But when the peds Dr came in he caught on to a serious heart problem. I say yes, if it only helps one newborn it is wonderful screening.

  • bitsyfae1 Aug 24, 2011

    To answer RMC10's question...

    I personally have never had a baby that didn't pass their pulse oximeter screening. We like to see the results between 95-100% oxygen saturation. Anything less and they get tested again.

    Thats not to say that I haven't otherwise put a baby with less than ideal pink coloring on a pulse oximeter with unsatisfactory results. This is 99% of the time a result of choking and not from a heart defect. If you have further questions about this procedure I'm sure your pediatrician can answer them for you.

    As I said, too many unanswered questions WRAL. I think you opened a can of worms.

  • bitsyfae1 Aug 24, 2011

    Obviously, the pulse oximeter is just a first line of defense. In no way would it replace further screening. And depending on what point it is done after 24 hours it can still give you a great reading, while there still could be a defect! It potentially is a false hope, but if one baby out of 10,000 is caught, then it is worth the two minutes it takes to do.

    Also, I'm sure the nurse that notice the blue fingernails immediately put the baby on the pulse oximeter! Also a note to about to be fingernail beds are completely different than the normal state of "acrocyanosis" that a majority of newborns have...bluish hands and feet...after birth.

    I think perhaps WRAL needed to be much more specific when it decided to post a story like this. Too many unanswered questions from the general population. Perhaps a follow up would be wise

  • baracus Aug 23, 2011

    "I would hope that whisking away babies for open heart surgery would be done more of a last line of defense, instead of the immediate line of defense as reported in the news story."

    The story doesn't say that. First, it doesn't sound like the kid in the story even had the pulse oximetry screening - the nurse noticed his nails were blue. Second, while the story says he was rushed off to emergency surgery, it is a little hard to believe that they did not do a echocardiogram first to see what they were dealing with before diving in. I don't think heart defects are the only thing that can cause low readings.

  • mhjmd Aug 23, 2011

    Hello. Physician here. Routine pulse oximetry screening in the nursery setting is very easy to do, and not something that I would object to at all (I/my nurses already get a pulse oximetry reading on any baby that so much as looks at us wrong).

    But I think that, because of the nature of congential heart defects and how/when some of them present, relying on a pulse oximeter to "rule-out" heart defects before discharge lends a false sense of security, and might serve to be just one more test/bit of technology that keeps doctors from actually LOOKING closely at the patient (as opposed to the monitor).

    If it's initiated simply to legally "CYA", as they say, that's the wrong reason to do it.

    I see no reason why parents could not request the screen.

  • RMC10 Aug 23, 2011

    Dr. Mask - won't this test, if done too early after birth where there are natural fluctuations and valves, lungs and veins settling in, result in too many heart surgeries too early. I would hope that whisking away babies for open heart surgery would be done more of a last line of defense, instead of the immediate line of defense as reported in the news story. I would hope doctors would consider the long term (negative) impact of being a forever patient. I know my doctor now uses a pulse oximeter, and even now I get false positive readings when stressed. To bitsyfae1, what do you routinely see on these readings, how many babies have out of norms results?

  • bitsyfae1 Aug 23, 2011

    We do this routinely on all newborns beginning at 24 hours of age at Wake Med. We, as in the nurses, not the doctors. And we have been doing this screening for some time least 4-5 years that I can remember anyway!

  • justbcauz Aug 23, 2011

    Does anyone know if this is something parents can request at local hospitals (Rex, WakeMed, etc.)?