Why should early screening for congenital heart defects in newborns?

The article is professionally consulted by Master, Doctor Pham Van Hung - Department of Medical Examination & Internal Medicine - Vinmec Danang International General Hospital.

Today, with the scientific and professional development of the medical team, birth defects can be screened early in the fetus and after birth.

Each year in Vietnam, 3,000 babies are born with severe congenital heart disease, of which about 20% of the newborns are discharged from hospital with undetected congenital heart defects. Therefore, it is necessary to screen echocardiography in the fetal period from the 14th week or soon after birth.
Congenital heart disease has a high risk of death if we delay in diagnosis and transfer children to experienced cardiovascular centers for treatment. It is the leading cause of death in the perinatal period and infancy compared with other birth defects.
Although the prognosis has improved significantly thanks to advances in diagnosis and therapeutic interventions, up to 40% of deaths shortly after birth and 60% of deaths in the neonatal period are due to heart disease congenitally caused.

2.1 Fetal echocardiography This method helps detect most heart defects during pregnancy, especially severe and life-threatening malformations of the baby immediately after birth. The best time to have a fetal echocardiogram is between 18-22 weeks of gestation. Because 90% of babies born with congenital heart disease have no prior risk factors. Therefore, fetal echocardiography is recommended for all pregnant women, especially those in high-risk groups.
Early diagnosis in the fetal period helps to intervene with heart disease if possible, or to decide to terminate the pregnancy early for complicated heart diseases. However, because the structure of the heart is still changing with gestational age, some mild congenital heart diseases may be missed, or be mitigated/disappeared at birth. Therefore, postpartum echocardiography is necessary to confirm the diagnosis.

2.2 Measuring SpO2 (skin oxygen saturation) Measuring SpO2 is measuring oxygen saturation in peripheral blood through a SpO2 probe clamped at the tip of the finger or toe. Normal oxygen saturation is above 90%, preferably 95-100% in neonates and does not differ much when measured in hands and feet. When SpO2 is less than 90% or the difference between right hand and foot is greater than or equal to 3%, it is called a positive test. Any child with a positive SpO2 test should also have an echocardiogram.
Test to measure SpO2 is best done from 24-48 hours after birth. An earlier test may result in a false-positive result due to the transition from the fetal to neonatal circulation and the instability of systemic oxygen saturation. Delayed screening reduces the chance of intervention (if possible) before the ductus arteriosus closes.
2.3 Echocardiography early after birth In the past few years, at some major obstetrics and gynecology hospitals in the country, newborn echocardiography has been performed as a routine screening with the aim of early detection of heart diseases. congenital in children. Echocardiography helps to accurately answer whether the baby is born with congenital heart disease, severe or mild heart defects, and needs early intervention in the neonatal period.
Master, Doctor Pham Van Hung has 30 years of experience in examination and treatment of internal diseases, especially in Cardiology: coronary arteries, heart failure, heart valves, arrhythmias. ..Master, Dr. Hung used to hold the position of Deputy Head of Cardiology Department and Head of Interventional Cardiology Unit at Da Nang General Hospital and is currently working at Department of Medical Examination and Internal Medicine, Internal Cardiology, and Cardiology. Interventional circuit at Vinmec Da Nang International General Hospital.