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Testing the Sensitivity and Specificity of right hand and foot pulse oximetry for the detection of congenital heart defects in Saudi Arabia.

Ahmed Saeed Azhar, Saad Abdullah Alsaedi, Yaroub Ahmed ALGanass, Bashair Mahmoud Magadmi

Background: Congenital Heart Defects (CHDs) are considered to be major health issues, as onefourth of affected infants develop critical illnesses that require urgent interventions. The early detection and treatment of CHDs are important for the prevention of serious complications that can be difficult to manage before the spontaneous closure of the ductus arteriosus, which maintains circulation of oxygenated blood. Pulse Oximetry (POX), which involves the use of a monitoring device to measure transcutaneous oxygen saturation, can be used as an inexpensive screening tool for CHDs. the present study aimed to evaluate the sensitivity and specificity of POX in the screening of CHDs among neonates in our institution. Methods: The study included all newborn neonates at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between December 2015 and December 2016. Oxygen saturation was measured at 24 h after birth and before discharge. Negative screening: oxygen saturation (SaO2) was ≥ 95% in the right hand and foot, with a difference in ≤ 3%. Positive screening: if the SaO2 was ≤ 90% in the right hand, or was ≤ 90% in the right foot, SaO2 was between 90% and 95% after three readings separated by an interval of 1 h in the right hand or foot, or the difference in SaO2 between the right hand and right foot was>3% after three readings separated by an interval of 1 h. Results: The 3326 neonates were included in this study. The calculated sensitivity was 70%, and the calculated specificity was 99.8%. There was a significant relationship between the number of positive cases and the number of confirmed cases by echocardiography (p=0.01). Conclusion: there was a simultaneous assessment of POX in the right foot and right hand at 24 h after birth and before discharge. POX is a sensitive and specific screening approach for the early detection of CHDs in neonates.