Evaluation of diagnostic accuracy of portable echocardiography in newborns

Congenital heart disease is the most common life-threatening anomaly in the neonatal period. Screening for this disease with portable echocardiography is crucial to diagnose in the early period, and it has benefits in saving time and decreasing the cost. Portable echocardiography has advantages of rapid access and lower costs and also has advantage that in intensive care units there is no necessity to move patients. With these advantages, it is aimed to compare the sensitivity of portable echocardiography comparing to standard echocardiography.

In this study, the portable echocardiography results of the sequentially enrolled newborns hospitalized in the neonatal departments are revised. Portable echocardiography results were verified with standard echocardiography in 83 (43%) female and 111 (57%) male patients. This study was planned as a study on diagnostic accuracy.

The gestational periods were between 24 weeks, 3 days and 42 weeks (average 35 weeks±4 weeks 3 days). Birth weights were between 500 and 4850 grams (average 2370±936 grams). The reason that portable echocardiography had been studied was murmur in 113 (58.2%) patients, cyanosis in 47 (24.2%) patients, prenatal anomaly in 12 (6.2%) patients, bradycardia in 12 (6.2%) patients, maternal diabetes in 6 (3.1%) patients and respiratory distress in 4 (2.1%) patients. Out of 194 patients 8 (4.1%) had differences between standard and portable echocardiography. Compared to standard echocardiography, portable echocardiography has the sensitivity values ranged between 99.3-100% and the specificity values ranged between 90.9-100% in diagnosis of specific CHD anomalies. Positive predictive value was between 50-100% whereas negative predictive value was between 97.9-100%. The agreement between results of two tests was determined as very good - kappa 0.886, 95%CI -0.821-0.951, p<0.0001.

It is demonstrated that portable echocardiography has a high sensitivity especially diagnosing major heart defects, and with advantages of rapid access and lower costs it is estimated that increasing usage of portable echocardiography could be beneficial.