Echocardiographic ultrasound screening assessment of the circulatory system of newborns delivered at basic level perinatal care centers

Abstract

BACKGROUND: For many years standards of medical care for newborns have been created and perfected with the goal of improving care, including early detection of congenital defects. OBJECTIVES: The objective of the study was to assess the circulatory system in newborns born at basic level of perinatal care centers and the comparison of specific parameters of cardiac function and structure according to the method of birth, body mass, sex, Apgar score, pulse oximetry results, and presence of other pathologies. MATERIAL AND METHODS: The study was carried out in 255 newborns aged 3-14 days. The children were assessed according to Apgar score, were weighed and pulse oximetry testing was carried out, and symptoms of neonatal jaundice or infection were taken into account. Each child was subjected to a physical examination and echocardiographic examination. RESULTS: Among the group studied, 3.5% of children had defects of the circulatory system and functional disorders. CONCLUSIONS: Pulse oximetry testing, due to its low level of invasiveness, high sensitivity and specificity, low cost and repeatability, should be used as the primary screening test, allowing for early detection of critical congenital heart defects (CHDs). It should be stressed that the test should be repeated before discharge of newborns from the neonatology department so as to avoid missing CHDs which are asymptomatic or mute at birth. Morphological and functional assessment of specific structures of the heart in delivered newborns showed correlation of the size of the left ventricle (LV) with body mass. The remaining factors, such as method of delivery, sex, neonatal jaundice, and audible murmur, were irrelevant. Routine cardiological assessment of healthy newborns is therefore not necessary.