Screening congenital cardiac diseases by hand-held echocardiography in low-risk newborns

This study aims to investigate the accuracy of hand-held echocardiography for identifying congenital cardiac diseases in newborns who appear to be healthy and who have no prenatal diagnosis for congenital anomaly and/or chromosomal abnormality. This is a prospective review of 1019 neonates who were consecutively born alive from term singleton pregnancies at the study center between January 2021 and January 2022. The stillborn neonates, the neonates born to multiple pregnancies, the neonates who had a prenatal diagnosis of congenital anomalies and/or chromosomal abnormalities and the neonates who were admitted to the neonatal intensive care unit upon delivery were excluded. Congenital cardiac defects were diagnosed in 266 newborns (26.1%). Atrial septal defect (ASD) and ventricular septal defect (VSD) were the most frequently diagnosed diseases, affecting 24.4% and 0.8% of the newborns respectively. The incidence of congenital cardiac diseases was significantly higher in male newborns than female newborns (p=0.035). Arterial O2 saturation was ≤ 95% in two newborns who were eventually diagnosed with tetralogy of Fallot. The newborns with congenital cardiac diseases had significantly lower arterial O2 saturation measured at right hand and right foot (p=0.031, p=0.027 and p=0.031 respectively). Hand-held echocardiography had a detection rate of 59.6% for ASD and 75% for VSD. The findings of hand-held echocardiography and transthoracic echocardiography correlated significantly (r=0.471, p=0.001). Hand-held echocardiography is a complementary tool for screening congenital cardiac diseases in low-risk newborns. This device can be used to strengthen physical examination, support transthoracic echocardiography, and prevent unnecessary referrals.