Fetal Echocardiography Vs. Pulse Oximetry Screening for Early Detection of Critical Congenital Heart Diseases and Neonatal Outcome

Abstract Background Delayed diagnosis of critical congenital heart disease (CCHD) in neonates increases morbidity and mortality. Prenatal diagnosis by fetal echocardiography (FE) allows preparing an appropriate perinatal and postnatal care, while postnatal pulse oximetry screening (POS) is recommended to increase detection of these conditions as well. Objective This study aimed at comparing outcome in neonates with congenital heart diseases diagnosed either by fetal echocardiography versus those screened by pulse oximeter. Patient and Methods This is an observational study conducted on 30 neonates admitted to Neonatal intensive care unit of Ain Shams University Maternity Hospital with CHD in the period from December 2019 to June 2021. Neonates were divided into 2 groups; Group1of neonates with CHD identified by FE and Group 2 included those detected by POS. Results Fifteen neonate diagnosed by fetal echocardiography were compared to another 15 newborns with congenital heart disease detected by pulse oximeter screening. There was no significant difference between both groups regarding demographic and maternal history. Clinical examination between the two groups did not differ either except for oxygen saturation, which was lower in the group diagnosed by pulse oximeter (p = 0.035). Fetal echocardiography could diagnose all types of cardiac abnormalities, unlike Pulse oximeter that detected only those with desaturation. Neither management nor outcome of patients differed based on the mode of diagnosis. Conclusions Fetal echocardiography can diagnose all types of structural cardiac anomalies antenatal, unlike postnatal pulse oximeter, which detects congenital cardiac defects with evidence of desaturation only.