NASHVILLE. Tenn. — The recently enacted legislation requiring that all newborns in Tennessee be evaluated with the simple pulse oximetry test to see if they have undetected congenital heart disease has paid off for one fortunate infant according to William F. Walsh, Professor of Pediatrics and Chief of Nurseries at the Monroe Carell Jr. Children’s Hospital at Vanderbilt.  Public Chapter 556 , sponsored by Senator Doug Overbey (R-Maryville) and Rep. Ryan Haynes (R-Knoxville), required the state’s Genetic Advisory Committee to develop a program to screen newborns for critical cyanotic congenital heart disease (CCCHD) using pulse oximetry by January 1, 2013.

“The baby boy had normal evaluations before delivery by his obstetrician and after birth passed his physical examination,” said Dr. Walsh.  “However the new screening test detected a low saturation of blood which was not visible to the naked eye. He was referred to a cardiologist where he was found to have a life threatening narrowing of the major blood vessel to the body. This narrowing naturally progresses over the first week of life and would have resulted in severe illness or even death if undetected. He was referred for surgery and is recovering.”

Dr. Walsh said most babies are found to have heart defects by the OB ultrasound exam before birth or have a murmur after birth. Dr. Walsh and Dr. Mouldedoux at Vanderbilt have found that about 12 babies a year are sent home with undetected critical heart disease.

“This is exactly why we passed this legislation,” said Senator Overbey, who also had undetected congenital heart defect at birth.  “I am pleased that this new law is working to save lives by making this screening available to all newborns in Tennessee.” 

Pulse oximetry is a non-invasive method which uses a light emitter with red and infrared LEDs that shines through a reasonably translucent site with good blood flow.  It is usually attached to the infant’s foot or the palm of the hand.  

“The chance of a baby who fails the screen of having critical heart disease is one in five, so not all babies that fail have defects,” added Walsh.  “There is also a chance that a baby can have a heart defect and pass the screen, so it is not fail-safe. However, adding the simple painless test to the newborn screening will save some babies and families from experiencing the potential devastation of a baby with a missed diagnosis who suddenly goes from looking very healthy to being on death’s door.”


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