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Newborn Screenings for Heart Defects Now Required in Missouri

Dr. John Burson, a pediatrician with Mercy Springfield, appears on KOLR10 News Daybreak to discuss the new mandatory newborn testing that went into effect at the beginning of the year.
Dr. John Burson, a pediatrician with Mercy, joins us this morning to tell us about new mandatory newborn testing that went into effect at the beginning of the year.

The screenings are for critical congenital heart disease, a term for a number of heart defects that can cause developmental delays or death if left untreated

24 hours after the birth of the baby, doctors are now required to take a pulse oximeter reading on the infants finger and toe.  "It measures the amount of oxygen in the blood in those two places," Burson explains.  Doctors are checking for a high percentage of oxygen in the blood throughout the newborn's body.

"It's a lot more subtle than you can detect by physical exam alone."

Reporter:  "What sort of conditions does this testing look for?"
Dr. Burson:  "There's a group we call critical congenital heart diseases, which are the changes in the way the blood flows from one side of the heart to the other.  The most common is hypo-plastic left heart syndrome. But there are a variety of other syndromes in there.  Not all critical congenital heart disease can be detected this way.  But this, in combination with physical exam, prenatal ultra-sound, is hopefully another tool to help us find some of those cases.

"If we miss these in the hospital - we can't detect them before the babies goes home, a lot of these children will die in the first month of life.  As those changes from life inside mom to life outside mom complete, there's something called patent ductus arteriosus that closes.  And some of these disorders depend on that patent ductus arteriosus remaining open for children to stay alive."   http://www.uptodate.com/contents/congenital-heart-disease-chd-in-the-newborn-presentation-and-screening-for-critical-chd

"Once we do that pulse-ox screen, which is very quick - it takes under a minute for the nurse to do that - we'll go ahead and we'll order an echocardiogram, which is basically an ultrasound of the heart. They can look at the different structures of the heart, the heart valves, the way the chambers work and then we'll be able to find the rest of these conditions."

Reporter:  "You said 1 to 2 out of 1,000 babies born have some sort of heart condition?"
Dr. Burson: "Right.  For these really serious ones, maybe a few less - maybe 2 or 3 in every 10,000.  But up to 1 or 2 in a thousand will have some form of heart disease."

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