[The value of SpO2 measurement in young infants in the primary care setting].

Hypoxia can be an early sign of infection, respiratory or circulatory pathology in infants. Since it is difficult to properly judge oxygen saturation solely by skin discoloration, it is preferable to objectify this parameter via pulse oximetry (PO). PO in young infants has shown to be feasible in the primary care setting.

Cost-effectiveness analysis of pulse oximetry screening for critical congenital heart defects following homebirth and early discharge.

Pulse oximetry (PO) screening is used to screen newborns for critical congenital heart defects (CCHD). Analyses performed in hospital settings suggest that PO screening is cost-effective. We assessed the costs and cost-effectiveness of PO screening in the Dutch perinatal care setting, with home births and early postnatal discharge, compared to a situation without PO screening.

Pulse Oximetry Screening Adapted to a System with Home Births: The Dutch Experience.

Neonatal screening for critical congenital heart defects is proven to be safe, accurate, and cost-effective. The screening has been implemented in many countries across all continents in the world. However, screening for critical congenital heart defects after home births had not been studied widely yet.

Accuracy of Pulse Oximetry Screening for Critical Congenital Heart Defects after Home Birth and Early Postnatal Discharge.

Objective: To assess the accuracy of pulse oximetry screening for critical congenital heart defects (CCHDs) in a setting with home births and early discharge after hospital deliveries, by using an adapted protocol fitting the work patterns of community midwives.

Study Design: Pre- and postductal oxygen saturations (SpO) were measured ≥1 hour after birth and on day 2 or 3. Screenings were positive if the SpO measurement was <90% or if 2 independent measures of pre- and postductal SpO were <95% and/or the pre-/postductal difference was >3%.

Neonatal Safety of Elective Family-Centered Caesarean Sections: A Cohort Study.

Background: Although little data are available concerning safety for newborns, family-centered caesarean sections (FCS) are increasingly implemented. With FCS mothers can see the delivery of their baby, followed by direct skin-to-skin contact. We evaluated the safety for newborns born with FCS in the Leiden University Medical Center (LUMC), where FCS was implemented in June 2014 for singleton pregnancies with a gestational age (GA) ≥38 weeks and without increased risks for respiratory morbidity.

The Breathing Effort of Very Preterm Infants at Birth.

Objective: To compare the respiratory effort of very preterm infants receiving positive pressure ventilation (PPV) with infants breathing on continuous positive airway pressure (CPAP), directly after birth.

Study Design: Recorded resuscitations of very preterm infants receiving PPV or CPAP after birth were analyzed retrospectively. The respiratory effort (minute volume and recruitment breaths [>8 mL/kg], heart rate, oxygen saturation, and oxygen requirement were analyzed for the first 2 minutes and in the fifth minute after birth.

Maternal acceptability of pulse oximetry screening at home after home birth or very early discharge.

Unlabelled: The Netherlands has a unique perinatal healthcare system with a high rate of home births and very early discharge after delivery in hospital. Although we demonstrated that pulse oximetry (PO) screening for critical congenital heart disease is feasible in the Netherlands, it is unknown whether parents find the screening acceptable when performed in home birth setting. We assessed the acceptability of PO screening to mothers after screening in home setting.

Pulse Oximetry Screening for Critical Congenital Heart Disease after Home Birth and Early Discharge.

Objectives: To assess the feasibility of pulse oximetry (PO) screening in settings with home births and very early discharge. We assessed this with an adapted protocol in The Netherlands.

Study Design: PO screening was performed in the Leiden region in hospitals and by community midwives.

The perfusion index of healthy term infants during transition at birth.

Unlabelled: Perfusion index is a continuous parameter provided by pulse oximetry and might be useful for evaluating hemodynamic changes at birth and identifying transitional problems. The objective was to describe perfusion index values in term infants immediately after birth. Perfusion index of 71 healthy term born infants were recorded during the first 10 min after birth, using a pulse oximetry sensor placed preductally.

Aspects of pulse oximetry screening for critical congenital heart defects: when, how and why?

Pulse oximetry (PO) screening for critical congenital heart defects (CCHD) has been studied extensively and is being increasingly implemented worldwide. This review provides an overview of all aspects of PO screening that need to be considered when introducing this methodology. PO screening for CCHD is effective, simple, quick, reliable, cost-effective and does not lead to extra burden for parents and caregivers.

Low signal quality pulse oximetry measurements in newborn infants are reliable for oxygen saturation but underestimate heart rate.

Aim: We assessed the influence of system messages (SyMs) on oxygen saturation (SpO2 ) and heart rate measurements after birth to see whether clinical decision-making changed if clinicians included SyM data.

Methods: The heart rate and SpO2 of term infants were recorded using Masimo pulse oximeters. Differences in means and standard deviations (SD) were calculated.

Pulse oximetry measures a lower heart rate at birth compared with electrocardiography.

Objective: To examine the effect of time after birth on heart rate (HR) measured by pulse oximetry (PO) (HRPO) and electrocardiography (ECG) (HRECG).

Study Design: HRECG and HRPO (collected at maximum sensitivity) were assessed in 53 term and preterm infants at birth. ECG electrodes and a PO sensor were attached as soon as possible and HRECG and HRPO were compared every 30 seconds from 1-10 minutes after birth.

Adapted protocol for pulse oximetry screening for congenital heart defects in a country with homebirths.

Unlabelled: Pulse oximetry has been recommended for neonatal screening for critical congenital heart defects (CCHD) and is now performed in several countries where most births take place in hospital. However, there is a wide variation in perinatal care in European countries, and studies are now recommended to determine the accuracy and cost-effectiveness of CCHD screening in individual countries. In the Netherlands, a large part of births are supervised by a community-based midwife, at home or at policlinics.