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Screening For Critical Congenital Heart Disease Using Pulse-Oximetry, The First Egyptian Multicentre Study

Published online by Cambridge University Press:  17 February 2025

Mohammad Eltahlawi Open the ORCID record for Mohammad Eltahlawi [Opens in a new window] ,
Alaa Elghamrawy ,
Maiy Hamdy Elsayed ,
Mona Hafez ,
Asmaa Elmesiry ,
Mohamed Bayomy ,
Hani Adel ,
Mahmoud Elfayoumy ,
Sahbaa Hafez  and
Said Morsy
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Mohammad Eltahlawi*
Affiliation:
Zagazig University, Cardiology Department, Zagazig, Egypt
Alaa Elghamrawy
Affiliation:
Ministry of Health, Elmahallah Cardiac Center, Elmahallah, Egypt
Maiy Hamdy Elsayed
Affiliation:
Ain Shams University, Cardiology Department, Cairo, Egypt
Mona Hafez
Affiliation:
Mansoura University, Pediatric Department, Mansoura, Egypt
Asmaa Elmesiry
Affiliation:
Tanta University, Pediatric Department, Tanta, Egypt
Mohamed Bayomy
Affiliation:
Alazhar University, Pediatric Department, Cairo, Egypt
Hani Adel
Affiliation:
Alexandria University, Pediatric Department, Alexandria, Egypt
Mahmoud Elfayoumy
Affiliation:
Alazhar University, Pediatric Department, Cairo, Egypt
Sahbaa Hafez
Affiliation:
Zagazig University, Pediatric Department, Zagazig, Egypt
Said Morsy
Affiliation:
Zagazig University, Pediatric Department, Zagazig, Egypt
Mahmoud Elhady
Affiliation:
Benha University, Benha, Egypt
Baher Nashy
Affiliation:
Zagazig University, Cardiology Department, Zagazig, Egypt
Mohamed Abo Elela
Affiliation:
Assuit University, Pediatric Department, Assuit, Egypt
*
Corresponding author: Mohammad Eltahlawi; Email: Tahlawi_basha@yahoo.com
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Abstract

Background:

Congenital heart Disease (CHD) is a significant cause of morbidity and mortality. Pulse-oximetry is a good non-invasive simple tool for critical CHD screening. Implications of this tool may be possible in certain areas and non-practical in others. We aim to report on the preliminary results of a recent ongoing protocol concerning the use of pulse-oximetry in detecting critical CHD in newborn in Egypt.

Patients & Methods:

All neonates born in or transferred to 10 university hospitals during the period between February and November 2023 and fulfilled the criteria of inclusion were screened for critical CHD by pulse-oximetry using Granelli protocol in the first 24–72 hours after birth.

Results:

During a 10-month pilot period, a total of 2392 neonates were screened. A total of 549 neonates (23%) tested positive (failed) screening. Among the positive cases, 213 neonates (42%) died during their hospital stay, while the remaining were discharged or scheduled for intervention. The positive cases underwent echocardiography that revealed CHD in the majority of cases (80.3%). Only 40 cases of those cases had cardiac defects that are classified as critical CHD with a prevalence of 16.7 per 1000 live births, while the rest of the cases have either simple (non-critical CHD) or persistent pulmonary hypertension. About 19.7% of positive cases have completely free echocardiograms without cardiac defects.

Conclusion:

The prevalence of critical CHD in Egypt is higher than the mean worldwide prevalence. The introduction of pulse-oximetry as a mass screening tool for critical CHD is possible and effective in low-income countries.

Keywords

Congenital heartpulse-oximetryscreening

Information

Type
Original Article
Information
Cardiology in the Young , Volume 35 , Issue 3 , March 2025 , pp. 539 - 544
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Copyright
© The Author(s), 2025. Published by Cambridge University Press

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References

Hoffman, JIE, Kaplan, S. The incidence of congenital heart disease. J Am Coll Cardiol [Internet] 2002; 39: 1890–1900. doi: 10.1016/S0735-1097(02)01886-7.Google ScholarPubMed
Hoffman, JIE. Incidence of congenital heart disease: II. Prenatal incidence. Pediatr Cardiol [Internet] 1995; 16: 155–165. doi: 10.1007/BF00794186.CrossRefGoogle ScholarPubMed
Kemper, AR, Mahle, WT, Martin, GR, et al. Strategies for implementing screening for critical congenital heart disease. Pediatrics [Internet] 2011; 128: e1259–e1267. doi: 10.1542/peds.2011-1317.Google ScholarPubMed
Ewer, AK, Middleton, LJ, Furmston, AT, et al. Pulse oximetry screening for congenital heart defects in newborn infants (PulseOx): a test accuracy study. Lancet [Internet] 2011; 378: 785–794. doi: 10.1016/S0140-6736(11)60753-8.Google ScholarPubMed
Thangaratinam, S, Brown, K, Zamora, J, Khan, KS, Ewer, AK. Pulse oximetry screening for critical congenital heart defects in asymptomatic newborn babies: a systematic review and meta-analysis. Lancet [Internet] 2012; 379: 2459–2464. doi: 10.1016/S0140-6736(12)60107-X.Google Scholar
Brown, KL, Ridout, DA, Hoskote, A, Verhulst, L, Ricci, M, Bull, C. Delayed diagnosis of congenital heart disease worsens preoperative condition and outcome of surgery in neonates. Heart [Internet] 2006; 92: 1298–1302. Available from: https://heart.bmj.com/content/92/9/1298.Google ScholarPubMed
Morrow, WR, Rosenthal, GL, Snyder, CS, et al. Endorsement of health and human services recommendation for pulse oximetry screening for critical congenital heart disease. Pediatrics 2012; 129: 190–192.Google Scholar
Ailes, EC, Gilboa, SM, Honein, MA, Oster, ME. Estimated number of infants detected and missed by critical congenital heart defect screening. Pediatrics [Internet] 2015; 135: 1000–1008. doi: 10.1542/peds.2014-3662.Google ScholarPubMed
Peterson, C, Dawson, A, Grosse, SD, et al. Hospitalizations, costs, and mortality among infants with critical congenital heart disease: how important is timely detection? Birth Defects Res Part A - Clin Mol Teratol 2013; 97: 664–672.CrossRefGoogle ScholarPubMed
Olney, RS, Ailes, EC, Sontag, MK. Detection of critical congenital heart defects: review of contributions from prenatal and newborn screening. Semin Perinatol 2015; 39: 230–237.Google ScholarPubMed
Granelli, ADW, Wennergren, M, Sandberg, K, et al. Impact of pulse oximetry screening on the detection of duct dependent congenital heart disease: a swedish prospective screening study in 39 821 newborns. BMJ 2009; 338: 145–148.Google Scholar
Liske, MR, Greeley, CS, Law, DJ, et al. Report of the Tennessee task force on screening newborn infants for critical congenital heart disease. Pediatrics 2006; 118: e1250–e1256.Google ScholarPubMed
Majani, N, Chillo, P, Slieker, MG, et al. Newborn screening for critical congenital heart disease in a low-resource setting; research protocol and preliminary results of the Tanzania pulse oximetry study. Glob Heart 2022; 17: 32.Google Scholar
Barreto, T. Pulse oximetry screening for critical congenital heart defects in newborns. Am Fam Physician 2019; 99: 421–422.Google ScholarPubMed
Hoffman, JIE, Kaplan, S. The incidence of congenital heart disease. J Am Coll Cardiol 2002; 39: 1890–1900.Google ScholarPubMed
Reller, MD, Strickland, MJ, Riehle-Colarusso, T, Mahle, WT, Correa, A. Prevalence of congenital heart defects in metropolitan Atlanta, 1998–2005. J Pediatr 2008; 153: 807–813.Google ScholarPubMed
Kumar, P. Universal pulse oximetry screening for early detection of critical congenital heart disease. Clin Med Insights Pediatr 2016; 10: 35–41. doi: 10.4137/CMPed.S33086.Google ScholarPubMed
Kluckow, M. Barriers to the implementation of newborn pulse oximetry screening: a different perspective. Int J Neonatal Screen 2018; 4: 4.Google Scholar
Plana, MN, Zamora, J, Suresh, G, Fernandez-Pineda, L, Thangaratinam, S, Ewer, AK. Pulse oximetry screening for critical congenital heart defects. Cochrane database Syst Rev 2018; 3: CD011912.Google ScholarPubMed
Siefkes, H, Kair, L, Tancredi, DJ, Vasquez, B, Garcia, L, Bedford-Mu, C, Lakshminrusimha, S. Oxygen saturation and perfusion index-based enhanced critical congenital heart disease screening. Am J Perinatol [Internet] 2020; 37: 158–165.Google ScholarPubMed
Siefkes, H, Oliveira, LC, Koppel, R, et al. Machine learning-based critical congenital heart disease screening using dual-site pulse oximetry measurements. J Am Heart Assoc 2024; 13.Google ScholarPubMed
Bradshaw, EA, Cuzzi, S, Kiernan, SC, Nagel, N, Becker, JA, Martin, GR. Feasibility of implementing pulse oximetry screening for congenital heart disease in a community hospital. J Perinatol 2012; 32: 710–715.Google Scholar
Sakrana, AA, Al-Zubaidi, SA, Nasr, MM, Helmy, EM, Al Ghamdi, SS, Tahlawi, ME. Cardiac magnetic resonance indices reflecting pulmonary regurgitation burden after tetralogy of fallot repair. Clin Radiol 2017; 72: 900.e9–900.e15.Google ScholarPubMed
Tissot, C, Singh, Y. Neonatal functional echocardiography. Curr Opin Pediatr 2020; 32: 235–244.Google ScholarPubMed
Sakrana, AA, Abdel Razek, AAK, Yousef, AM, El Tahlawi, MA, Gadelhak, BN. Cardiac magnetic resonance-derived indexed volumes and volume ratios of the cardiac chambers discriminating Group 2 Pulmonary hypertension from other world health organization groups. J Comput Assist Tomogr 2021; 45: 59–64.Google ScholarPubMed
El Tahlawi, M, Bonello, B, Fraisse, A. Radiofrequency recanalization of an occluded long segment left pulmonary artery in bidirectional cavopulmonary anastomosis. Catheter Cardiovasc Interv 2010; 75: 773–777.CrossRefGoogle ScholarPubMed
Lannering, K, Kazamia, K, Bergman, G, et al. Screening for critical congenital heart defects in Sweden. Obstet Gynecol Surv [Internet] 2024; 79: 185–187.CrossRefGoogle Scholar
Sakai-Bizmark, R, Chang, R-KR, Martin, GR, et al. Current Postlaunch Implementation of State Mandates of Newborn Screening for Critical Congenital Heart Disease by Pulse Oximetry in US. States and Hospitals. Am J Perinatol [Internet] 2024; 41: E550–E562.Google ScholarPubMed