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>> Hi, I'm Anita Saxena.
I'm professor of cardiology at the All India Institute
of Medical Sciences in New Delhi, India,
and I'm here presenting a poster on
Utility of Pulse Oximetry and Bedside Echocardiography
in identifying critical heart defects in neonates.
And this study has been actually carried out
in a community-setting hospital which is just across
my hospital and this is based on recruitment of more than
17,000 neonates who have been screened within
the first 48 hours of life, and they've had oximetry
evaluation by non-invasive pulse oximetry as well as
a bedside echocardiography to find out if there
is any abnormality.
And as you can see here, there were very few children
who had some sort of clinical features like
cyanosis or a murmur, but we did pick up a large
number of cases with congenital heart disease,
and this gave us a prevalence of 7.3 per 1000.
Of course in addition, we did pick up a lot of small,
small VSDs which probably would have gone unnoticed
but for echocardiography.
But the major or so-called those abnormalities which
required early intervention were seen in about 2.8 per 1000
live births as seen here.
I think the important point that I wanted to highlight
in the study was that the pulse oximetry which has
been recently highlighted as a very good non-invasive
tool to diagnosis congenital heart disease was not really
found to be so good in our hands.
And as you can see the sensitivity of diagnosing
the congenital heart disease was as low as 30%.
Of course it had a very good specificity.
This goes in quite in contrast with what has been recently
published in Glancy 2011, but it was found to be
a very useful modality and is being recommended
as a modality for all babies before they are discharged
from an ICU.
I think the reason could be that we have a lot
of unbooked pregnancies and a lot of mothers coming
in and delivering with babies with asphyxia,
and I think respiratory issues have probably contributed
to this low sensitivity of the pulse oximetry.
But yes, echocardiography was already on and we did
manage to find almost the same spectrum as has been
reported from the Western literature.
Thank you.