Page 15 - WBC-toolkit

FIRST STAGES

At birth

Screening after 24- 72 h delivery

1. To aid in the early detection of critical congenital heart disease (CCHD) in Newborns before discharge from the Hospital.
2. To develop strategies for the implementation of safe, effective, and efficient screening.

Newborn screening for critical CHDs involves a simple bedside test called pulse oximetry. This test estimates the amount of oxygen in a baby’s blood. Low levels of oxygen in the blood
can be a sign of a critical CHD. The test is done using a machine called a pulse oximeter, with sensors placed on the baby's skin. The test is painless and takes only a few minutes.

The seven primary targets of CCHD screening are:
1. Hypoplastic Left Heart Syndrome
2. Pulmonary Atresia (with intact atrial septum)
3. Tetralogy of Fallot
4. Total Anomalous Pulmonary Venous Return
5. Transposition of the Great Arteries
6. Tricuspid Atresia
7. Truncus Arteriosus
Secondary screening targets include:
1. Aortic Arch Atresia or Hypoplasia
2. Interrupted Aortic Arch
3. Coarctation of the Aorta
4. Double-outlet right ventricle
5. Epstein's anomaly
6. Pulmonary stenosis/atresia
7. Atrioventricular septal defect
8. Ventricular septal defect
9. Other single ventricle defect (other than hypoplastic left heart syndrome and tricuspid atresia)

The secondary defects can be just as serious as primary screening targets but may not be detected as consistently with pulse oximeter screening.
Passed Screens- An oxygen saturation measure that is ≥95% in the right hand or foot with a ≤3% absolute difference between the right hand or foot is considered a passed screen and

screening would end.
Failed Screen- An oxygen saturation measure is <90% (in the initial screen or in repeat screens), Oxygen saturation is <95% in the right hand and foot on three measures, each

separated by one hour, or >3% absolute difference exists in oxygen saturation between the right hand and foot on three measures, each separated by one hour.
Any infant who fails the screen should have a diagnostic echocardiogram. The Newborns’ pediatrician should be notified immediately and the infant might need to be seen by a

cardiologist.

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