Feds urge wider use of heart test on newborns

(CBS News) 

Congenital heart defects are the leading cause of birth defect-related deaths. But what if a simple, one-dollar screening test could help save thousands of newborns' lives? Such a test exists, but it's not done routinely in the United States.

CBS News Medical Correspondent, Dr. Jennifer Ashton says that's about to change.

The test is called pulse oximetry screening. And today, a special federal advisory committee is unveiling a new nationwide strategy to use this very effective method to screen newborns for congenital heart disease.

"I thought that I was going to have a normal baby. A normal, healthy baby," said Jodi Koravos, who had an uncomplicated pregnancy and a routine delivery.

At first everything seemed fine. And then, without warning, it wasn't.

"It's life changing. In that one instant, everything changed," Koravos adds.

Just a few hours after her baby, Alex, was born, a nurse told her, her baby was turning blue.

"There's no way to explain it. It's almost like nothing else matters in the world. But your baby has a problem in his heart and you need to take care of it," she said.

Alex's body was not getting enough oxygen. A simple and inexpensive test called pulse oximetry, or pulse ox, helped determine the cause - a congenital heart defect.

"I never heard of pulse ox before," Koravos points out. "I had never heard of congenital heart defects before and I truly didn't know that this was even a possibility."

But congenital heart defects are all too common -- 40,000 babies are born with them each year. From 1999-2006, congenital heart defects caused nearly 28,000 deaths.

"It's particularly important that we identify babies with these critical congenital heart defects, because if we don't they can go home from the nursery, and very rapidly die," explained Dr. Alex Kemper of the federal advisory panel.

No states currently require pulse oximetry screening of newborns, but at a hospital on Long Island that "The Early Show" visited, all babies are tested. A sensor is taped to the foot. The red light painlessly measures how much oxygen is in the blood.

According to Dr. Dennis Davidson, of the North Shore-LIJ Health System, "It's an easy test to do. The parameters for deciding what is normal or abnormal are clear cut. The oxygen saturation has to be greater than 95 percent at 24 hours of age."

As for baby, Alex, his oxygen level was only in the 50s. He needed emergency heart surgery.

"You see this body that's only being maintained by machines. He had tubes coming out of everywhere on his body," Koravos said.

Alex is now on the road to recovery. He has a big scar on his chest and will need two more surgeries. His mother checks his oxygen levels at home twice a day. As you can hear, he now gets plenty.

"If it weren't for pulse ox, Alex wouldn't have lived," a grateful Koravos said.

If this test is so easy and cheap, why aren't all hospitals doing it?

"Like a lot of things there are logistical factors," Ashton points out. "On the good side -- this is a cheap test, it costs about $1 per baby, it's a quick test in the hands of a skilled technician -- takes only 45 seconds.

"What you do if a hospital or baby gets a result needs to be worked out -- not every hospital has access to pediatric cardiologists, and the more specialized test needs to be done if the result is abnormal.

"The test can be a little less than perfect in darker skinned babies so Hispanic and African-American babies may have results less than ideal. So again, the logistics need to be worked out."

Are there other tests that can be done?

"Absolutely, prenatal ultrasounds usually done 20 weeks during pregnancy are accurate in detecting 75 percent of these congenital heart defects. When you combine that with a physical exam done in the nursery and pulse oximetry screening, 92 percent will be detected.

"Tthat number is not 100 percent. It's important to remember some of the babies may not have symptoms in the first day of life, they can go home from the hospital and rapidly decompensate, get sick and die. So low-cost, high benefit test, I think, we'll be seeing a lot more of this."

Next week, New Jersey will become the first state in the nation to require that all babies be screened using pulse oximetry.

[puzzler125]

What I find really scary is that the level of medical care you get depends on where you live to such an extent that basic care is not available in many areas. When I grew up in NY excellent medical care was available but when I had a gallbladder attack in rural Ohio and needed a sonogram I had to wait four days because the hospital didn't have a technician available. Pulse oximetry was done routinely when I worked in NY area hospitals but I didn't see it in the Ohio hospital.