Screening seeks out babies' heart defects

ABU DHABI // A new method of screening babies for heart disease is helping save lives.

Pulse oximetry uses a light probe to measure oxygen levels in the heart's red blood cells during the first 24 hours of a baby's life.

The Health Authority-Abu Dhabi (Haad) introduced it at Al Ain's Tawam Hospital in January last year as part of a new screening programme for newborns, and one per cent of the 4,473 babies screened in 2011 were found to have congenital heart disease (CHD).

A further 0.3-0.5 per cent were found to have critical congenital heart disease (CCHD), which requires urgent treatment and is the main target of the programme.

The children were the first in the country to undergo pulse oximetry.

Follow-up examinations confirmed 10 cases of CCHD, while three false positives were also discovered.

All but two of the babies who tested positive survived.

Dr Mohamed Hamdan, the head of paediatric cardiology at Tawam Hospital, said pulse oximetry provides a more accurate reading of oxygen levels, reducing the number of misdiagnosed cases of CCHD.

"The equipment has become much more sensitive, so the chances of a false positive or false negative result are much less."

In comparison, between 2008 and 2010, Tawam Hospital detected potentially fatal heart problems in three to five babies a year, Dr Hamdan said.

"Death would have been expected to be between 15 and 30 per cent before cardiac surgery, and additional 10 to 20 per cent after surgery. The total survival rate would have been 60 to 70 per cent."

That survival rate does not factor in the babies who died after CCHD was not diagnosed at birth.

In most cases, early detection is vital. Late diagnoses can result in death or severe neurological impairment.

With pulse oximetry able to diagnose cases at a higher rate than other methods, such as foetal echocardiography, which can miss up to half of cases, the latest results from Tawam indicate the direction the country's other birthing hospitals might soon follow.

Al Rahba Hospital in the north of Abu Dhabi emirate adopted pulse oximetry in February, but no incidents of CCHD have yet been detected.

Corniche Hospital in the capital has also adopted pulse oximetry.