Public Health England has announced that it wants to run a pilot on a new screening tool to test babies for heart problems. What’s it all about?
Congenital Heart Defects/Disease (CHD)
Congenital heart disease is a term used to describe a range of conditions where a heart abnormality or defect develops when a baby is still in the womb. Approximately 3500 babies every year are affected and diagnosis can be difficult.
There are lots of different types of congenital heart disease and the treatment varies widely too. Some babies will just need monitoring, some might need medicines and some may need specialist heart surgery. Unfortunately, CHD can be serious and even life-threatening.
What are we doing at the moment?
Currently we already have 2 screening programmes in place:
1) All pregnant women are offered an ultrasound scan at around 20 weeks to look at the overall make-up of the heart. This will pick up some of the problems.
2) All babies should have a newborn check within the first 72 hours of life and then another check at 6-8 weeks’ age. During these checks, someone listens to the heart to see if they can hear any abnormalities. This will pick up some of the problems too.
Together these identify most cases of CHD, but there are still some that will slip through the net.
Why the new test?
There is another way to look for heart problems using something called a pulse oximeter or oxygen saturation monitor. This measures the level of oxygen in a person’s blood and a low reading could be due to a heart defect. So it gives us another tool to help pick up those babies that might have problems.
It’s actually quite a simple test. The technology has been around for years, and we use it in routine medical care, but we haven’t used it to screen babies for heart defects until now.
Why are we not using it already?
It’s important to remember that screening often raises more questions than it answers!
Measuring the oxygen in babies’ blood is not a perfect way of looking for congenital heart defects. You can get low levels because of other problems, and having normal levels doesn’t mean you are absolutely fine either! So we have to be careful how we use it to make sure we don’t end up worrying people unnecessarily or giving them a false sense of reassurance.
The UK National Screening Committee looked at all the research and evidence we have for this test before it came to recommending the pilot. This tool won’t diagnose babies with a heart problem. What it could do is identify babies that need to have further tests to see if they have the condition - that’s what screening means. But it needs to be as accurate as possible.
The plan is to measure oxygen levels in babies soon after that are born - probably at the time of their routine baby check. This will hopefully identify babies that need further testing.
The pilot is also being carried out to look at specific questions, such as:
- Which babies should we be screening? All of them or those at highest risk?
- What impact is screening going to have on workload? How is this going to affect care?
- What if it picks up other conditions? What should we do?
- How do we make sure that staff are properly trained to do it?
It might turn out not to be a good idea overall, but running the pilot is an important way to find out. Which hospitals will run the pilot and for how long hasn’t been decided yet, but we should know soon.
Remember: It will not detect all types of CHD, but it might help us pick up a few more than we are already.
Want more information?
Check out the Online Health Alert I did for ITV This Morning on congenital heart disease.
If you want more information on the screening pilot, here’s a FAQ from the UK National Screening Committee website.