Adapted protocol for pulse oximetry screening for congenital heart defects in a country with homebirths

Narayen, Ilona C.; Blom, Nico A.; Verhart, Marjolein S.; Smit, Marrit; Posthumus, Fennie; Broek, A.J.M. van den; Havers, Hester M.; Haak, Monique C.; Pas, Arjan B. te

doi:10.1007/s00431-014-2371-x

Cited by 19 publications

(19 citation statements)

References 12 publications

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Section: Discussionmentioning

confidence: 99%

“…As analyzed by Narayen et al [13,14], the perinatal health care system in the Netherlands is unique due to its high incidence of home births and early discharge after uncomplicated deliveries. In total, 33% of all low-risk deliveries are supervised by a community midwife, of which 55% occur at home and 45% at a birthing facility or policlinic [13,14]. Therefore, it has been estimated that implementation of a universal pulse oximetry screening of CCHD in the Netherlands would require the provision of pulse oximeters and adequate training to all 1,800 community midwives [13].…”

Section: Discussionmentioning

confidence: 99%

“…Earlier studies have shown the feasibility of home-birth screening of CCHD with hospital-grade portable pulse oximeters [13,14,23]. Besides the Netherlands, rates of planned out-of-hospital birth (i.e., births intended to occur at home or at a freestanding birth center) have increased in high- and middle-income countries [24,25,26].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, hospital-grade pulse oximeters are used in all screening programs [2,5,6,7,8,9,13,14]. Nevertheless, the price of such devices is a limitation for the extension of the CCHD pulse oximetry screening to home births and low-resource settings.…”

Section: Introductionmentioning

confidence: 99%

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Reliability and Validity of a Smartphone-Paired Pulse Oximeter for Screening of Critical Congenital Heart Defects in Newborns

Huizing

Villamor-Martínez²,

Chavagne³

et al. 2017

Neonatology

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Background: Barriers to widespread implementation of pulse oximetry screening of critical congenital heart defects (CCHD) in newborns include increasing trends of out-of-hospital births and cost of equipment. In recent years, smartphone-compatible pulse oximeters have appeared on the market, but the validity of such devices in the setting of CCHD screening has not been evaluated. Objectives: To compare the performance in CCHD screening of a smartphone-paired pulse oximeter (Masimo iSpO₂-Rx™) and a hospital-grade pulse oximeter (Masimo Radical-7™). Methods: Preductal (right hand) and postductal (either foot) saturations were determined in a population of 201 term newborns by 2 independent teams, one using the Radical-7 and the other using the iSpO₂-Rx. Bland-Altman analysis was applied to calculate mean bias and 95% limits of agreement between the 2 pulse oximeters. Results: For the preductal oxygen saturation, the mean bias (Radical-7 minus iSpO₂-Rx) was -0.08 (SD 1.76) and the lower and upper limits of agreement were -3.52 and 3.36, respectively. For the postductal oxygen saturation, the mean bias was -0.11 (SD 1.68) and the lower and upper limits of agreement were -3.49 and 3.18, respectively. In addition, the iSpO₂-Rx provided reliable measurements of saturations below 95% in a group of 12 infants admitted to the neonatal intensive care unit. Conclusions: Our data suggest that CCHD screening with the Masimo iSpO₂-Rx is feasible and accurate. The use of reliable smartphone-paired pulse oximeters may contribute to the extension of CCHD screening to home births and low resource settings.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Reliability and Validity of a Smartphone-Paired Pulse Oximeter for Screening of Critical Congenital Heart Defects in Newborns

Huizing

Villamor-Martínez²,

Chavagne³

et al. 2017

Neonatology

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“…Also, in Wisconsin, with a home birth rate of 1.67%, screening could be obtained in only one-third of all home births 51. In the Netherlands, 30% of births are supervised by community midwives, in birthing facilities or at home and an adjusted screening protocol has been developed to fit in the working scheme of the midwives 52 53…”

Section: Settingmentioning

confidence: 99%

Aspects of pulse oximetry screening for critical congenital heart defects: when, how and why?

Narayen

Blom

Ewer

et al. 2015

Arch Dis Child Fetal Neonatal Ed

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Pulse oximetry (PO) screening for critical congenital heart defects (CCHD) has been studied extensively and is being increasingly implemented worldwide. This review provides an overview of all aspects of PO screening that need to be considered when introducing this methodology. PO screening for CCHD is effective, simple, quick, reliable, cost-effective and does not lead to extra burden for parents and caregivers. Test accuracy can be influenced by targets definition, gestational age, timing of screening and antenatal detection of CCHD. Early screening can lead to more false positive screenings, but has the potential to detect significant pathology earlier. There is no apparent difference in accuracy between screening with post-ductal measurements only, compared with screening using pre-ductal and post-ductal measurements. However, adding pre-ductal measurements identifies cases of CCHD which would have been missed by post-ductal screening. Screening at higher altitudes leads to more false positives. Important non-cardiac pathology is found in 35-74% of false positives in large studies. Screening is feasible in neonatal intensive care units and out-of-hospital births. Training caregivers, simplifying the algorithm and using computer-based interpretation tools can improve the quality of the screening. Caregivers need to consider all aspects of screening to enable them to choose an optimal protocol for implementation of CCHD screening in their specific setting.

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Integrale geboortezorg – medisch-verloskundige en sociaal-maatschappelijke aandachtspunten

Wildschut

Groot

Galjaard

et al. 2018

Integrale Geboortezorg

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Adapted protocol for pulse oximetry screening for congenital heart defects in a country with homebirths

Abstract: the provided protocol might be useful for other countries that are planning to implement CCHD screening after homebirths or early discharge from hospital.

Cited by 19 publications

References 12 publications

Reliability and Validity of a Smartphone-Paired Pulse Oximeter for Screening of Critical Congenital Heart Defects in Newborns

Reliability and Validity of a Smartphone-Paired Pulse Oximeter for Screening of Critical Congenital Heart Defects in Newborns

Aspects of pulse oximetry screening for critical congenital heart defects: when, how and why?

Integrale geboortezorg – medisch-verloskundige en sociaal-maatschappelijke aandachtspunten

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