Оптимізація діагностики вроджених вад серця у новонароджених в ранньому неонатальному періоді

Abstract

The objective of the study is to optimize diagnosis of congenital heart defects (CHD) at newborns in the early neonatal period. Patients and methods. Screening pulse oximetry performed to 387 term neonates aged 24 - 48 hours of life by measuring of the blood saturation (SpO2) on right hand and either foot. Results. Reduction of SpO2 below 95% was observed in 12 neonates (3,1% ± 0,9). Echocardiography verified CHD in all neonates with reduced SpO2. Sensitivity of systolic murmur in the diagnosis of CHD is 90,1% (95% [CI 67,9 – 98,2]), specificity - 77,2% (95% [CI 75,5 – 77,8]). Pairwise comparisons showed significant differences (p ≤ 0,05) between the SpO2 of newborns with critical CHD and healthy children, as well as between neonates with small VSD and children with critical CHD (p ≤ 0,05). Sensitivity of pulse oximetry as method of diagnosis of critical CHD is 100% (95% [CI 78,4-100,0]), specificity - 100% (95% [CI 99,3 – 100,0]). Conclusion. SpO2 less than 95% indicates to a presence critical CHD. Specificity and sensitivity of pulse oximetry as a screening test for early diagnosis of critical congenital heart defects was 100%.