Implementation of pulse oximetry screening in a Danish maternity ward

Detecting critical congenital heart disease (CCHD) by prenatal ultrasound and routine examination of newborns is insufficient, and pulse oximetry screening (POS) has been recommended. POS has been implemented by some Danish maternity wards but not by all. However, no Danish studies of POS have been published. This study evaluates the first year with POS at Kolding Hospital, the Southern Region of Denmark.

All apparently healthy newborns were offered POS few hours postpartum. Both pre- and post-ductal POS were carried out using a well-known protocol and registered as POS approved; POS repeated and approved; or POS not approved, paediatrician called. Paediatricians registered clinical data, and general experiences regarding POS were collected.

POS was performed in 2,855 newborns; 2,715 were approved immediately, 81 were repeated. Paediatric assistance was required for 59 newborns; 16 could stay in the maternity ward following assessment, while 18 were admitted for observation until their saturation normalised. One newborn had CCHD, while ten had other conditions needing treatment and 14 had more benign respiratory disorders. One sick newborn would not have been picked up by post-ductal screening only. No midwives performing the screening and no parents refrained from POS.

Early POS as part of the routine examination few hours postpartum seemed natural to midwives and parents but induced an increased false-positive rate. Early POS may discover other serious conditions in time for intervention.

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