Why is pulse oximetry testing important?

Coleen  Boyle, PhD, MS
Public Health & General Preventive Medicine
Some babies with a critical congenital heart defect or disease (critical CHD) appear healthy at first and may be sent home before their critical CHD is detected.  Newborn screening for critical CHD is a tool that works with prenatal diagnosis and physical exams after birth to improve detection of critical CHD.

When babies with an undiagnosed critical CHD leave the hospital, they might have very serious problems, such as cardiac collapse (when a baby’s heart stops working properly and can’t get oxygen to the body) or death within the first few days or weeks they are at home.

If a critical CHD is diagnosed before a baby leaves the hospital, doctors can provide care and treatment that may prevent later health problems or even death. They can also better plan treatment for a baby with a critical CHD, helping the baby have surgery or other treatment when he or she is stable, not in an emergency situation.

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Some congenital heart defects do not show signs within the first days or even weeks of life. Sometimes babies with significant congenital heart disease may not have a murmur after birth. Therefore, some babies may not show signs of significant congenital heart disease until after they become very sick. If healthcare providers discover a heart problem before a baby becomes ill, then the baby will have a better chance to do well with any necessary surgeries or procedures. Early diagnosis of the heart problem may also prevent damage to other organs that may occur when a baby becomes sick due to congenital heart disease.
While pulse oximetry screening cannot rule out all forms of congenital heart disease, it is a good starting point for evaluating many serious types of congenital heart defects. In 2011, the U.S. Department of Health and Human Services recommended that pulse oximetry screening should be included in the routine evaluation that all newborn babies undergo before they are discharged from the hospital after birth. More and more states are adopting this test as a routine procedure to be done on all newborn babies before they go home from the hospital.

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