Wednesday, July 29, 2015

Think Prenatal Ultrasound and Newborn Pulse Oximetry Screening Will Find All Neonatal Coarctations? Think Again!

By: Lewis First, MD, MS; Editor-in-Chief      

Bridget Coila
     We have been taught to carefully check newborns for distal pulses and listen for murmurs in the first few days after birth to make sure we are not missing a coarctation of the aorta.  Add in prenatal ultrasound screening and newborn pulse oximetry screening and you might think no coarctation will escape early detection.   
      Well, Lannering et al. (doi: 10.1542/peds.2015-1155) prove that assumption wrong in a review of infants seen with this cardiac disorder between 2003 to 2012 in their referral area.  The authors find that almost 50% of the 90 cases diagnosed were not identified prenatally or screened positive in the nursery leaving a large number to be picked up on follow-up visits or because the infant became sick upon discharge as the ductus closed.   
      If there was ever a reason to make sure we are doing good bread and butter physicals on our newborns, not just in the nursery but in their early postnatal visits to the office, this article will make you a believer.  Take heart and read more about what the authors recommend to avoid missing this important neonatal cardiac disorder.

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