Newborn screening for critical congenital heart disease (CCHD) that has been offered at Scarborough and Rouge Hospital (SRH) for nearly three years will soon be available to infants across Ontario.
CCHD refers to a condition where a baby’s heart, or major blood vessels around the heart, has not formed properly. CCHD screening is a simple test that measures the level of oxygen in a newborn’s blood. Low levels of oxygen in the blood can mean that the baby may have a problem with their heart.
CCHD screening is done using pulse oximetry; a non-invasive, point-of-care test uses a sensor with a light that is placed on the baby’s right hand and one foot. If there is a difference between the readings from the top limb and the bottom limb, physicians can perform more in-depth tests to rule out a heart defect. The test is done between 24 and 48 hours after the baby’s birth.
The Ontario government recently announced that CCHD screening would be added to the 29 conditions newborns are screened for through the provincial program Newborn Screening Ontario.
“We are so pleased that this potentially lifesaving test is being added to the wide range of serious, but treatable diseases that we screen for in newborns,” said Dr. Peter Azzopardi, Medical Director and Corporate Chief of Paediatrics for SRH’s Birchmount and General sites.
“We began this evidence-based screening in September 2012 at our Birchmount and General sites in order to ensure that every baby born at our hospital was getting the very best care possible.”
Dr. Karen Chang, Chief of Paediatrics for SRH’s Centenary site, agrees, adding that “the Centenary site has also been an early adopter of the screening with a protocol in place for the last two years.”
“SRH has long been a progressive, forward thinking hospital when it comes to newborn screening,” explains SRH Paediatrician Dr. Kushal Raghubir.
“For instance, in 1996, we pioneered universal screening for sickle cell disease for all infants born at the hospital; a process that was ultimately adopted at all hospitals across Ontario. Our leadership in CCHD screening builds on this proud history.”
In developing the CCHD screening protocol, the hospital worked closely with its two midwifery partners – Diversity Midwives and Sage-Femmes Midwives – to ensure a standard process.
“Our midwives have been involved every step of the way, and actually helped to spearhead the use of the screening at the hospital,” said Tama Cross, SRH Midwifery Division Head, Birchmount and General sites.
“What’s more, we are trained to perform CCHD screening both in hospital and in our patients’ homes for those who choose to have home births, or who leave the hospital shortly after giving birth.”
Dr. Azzopardi points out that the use of CCHD screening has definitely helped to pick up potentially fatal heart issues in babies.
“Just recently, we had a baby who was almost ready to go home and clinically, the baby looked well, but when the nurses did this test, the baby had a low oxygen level. The baby immediately was transferred to Sick Kids Hospital and had surgery. If that test hadn’t been done, there’s a good chance that baby may not have survived.”
CCHD screening will be expanded to all newborns in Ontario by January 2018.