8
8 You delivered a full term baby boy in your health center.
There was an initial cyanosis on the first 5 minutes but he
turned pink with a healthy cry thereafter. The parents
were concerned about a congenital heart defect since the
mother had a viral infection during pregnancy. They woud
like to make sure there are no problems. Your physical
exam of the baby was normal. What can you do to assure
the parents about the baby’s condition?
A. Explain about acrocyanosis in infants
B. Do a pulse oximetry evaluation
C. Request for an echocardiogram
D. Refer to a pediatric cardiologist
Screening for critical congenital
heart disease with pulse oximetry is
becoming an increasingly common
practice. Pulse oximetry can detect
mild levels of hypoxemia in infants
with congenital heart disease who
do not have obvious examination
findings, such as a murmur or
cyanosis (Thangaratinam et al.,
2012). Screening is directed at
identifying hypoplastic left heart
syndrome, pulmonary atresia,
tetralogy of Fallot, total anomalous
pulmonary venous return,
transposition of the great arteries,
tricuspid atresia, and truncus
arteriosus. Scrafter 24 hours of life
by placing a pulse oximetry probe on
the right hand and either foot. A
positive screening test result meets
the following criteria: (1) SaO2 less
than 90% in either extremity, (2)
SaO2 less than 95% in both upper
and lower extremities on three
measurements with each
measurement separated by 1 hour,
or (3) SaO2 difference of greater
than 3% between the upper and
lower extremities (Mahle et al.,
2012). Positive screening warrants
referral to the specialist for an
echocardiogram screening should be
done