Newborn pulse oximetry screening

What is pulse oximetry?

Pulse oximetry is a quick, simple test that does not hurt your baby. It tells us about the amount of oxygen in your baby’s blood.

Why is it being done?

Pulse oximetry is a screening test. Screening tests help identify apparently healthy people who may be at increased risk of a medical condition, enabling earlier treatment or better informed decisions. The use of pulse oximetry can detect serious heart conditions that may not have been picked up by antenatal ultrasound or examination of your baby.

How is the screening test done?

A small sensor which is attached to a blood oxygen monitoring machine (pulse oximeter or ‘sats’ machine) is placed around your baby’s right wrist. The sensor shines a red light through your baby’s skin and can calculate your baby’s blood oxygen level within a few minutes. This test is then repeated on one of your baby’s feet. This screening test can be done while you are holding and / or feeding your baby and is not painful.

When is this screening test done?

This screening test will done while you are on the postnatal ward or Midwifery Led Unit, and ideally but not always, when your baby is between four to eight hours of age. Usually the screening will be carried out after you and your baby have been transferred to the postnatal ward, but sometimes it will happen before you are discharged from the delivery suite.

Consent

After reading this information and discussing the test with your midwife or doctor, you will be asked to give your verbal consent for the screening.

When will I know the result?

You will be told the results immediately and they will also be noted in your baby’s medical record.

What happens if the reading is not normal?

Low oxygen levels can occur in normal newborn babies as they are adapting after birth, especially in the first few hours after birth. If the test is not normal, a repeat test will be performed after a period of time. If this repeat test is normal and your baby is well, then no further action is needed.

If a repeat screening continues to show low oxygen levels a paediatric / neonatal doctor will review your baby. Your baby may need to be admitted to the Neonatal Unit for observation and further tests.

• Low oxygen levels can also occur in babies with an infection or in babies who have swallowed meconium whilst in the womb.

• It may be necessary to rule out serious cardiac conditions by doing an echocardiogram (ultrasound scan of the heart); you and your baby may need to be transferred to another hospital for this.

• Your baby may need further investigations.

If further tests are needed, your doctor will discuss your baby’s options with you. Please ask questions or raise any concerns you may have with the staff looking after your baby. No decisions about treatment will be made without you giving consent first. Remember you can withdraw your consent for treatment at any time.

Will this test pick up all serious heart conditions?

Pulse oximetry screening is designed to detect heart conditions that are linked with a low oxygen level in the baby’s blood. Not all serious heart conditions will do this; so it is important that if you have any concerns either before you take your baby home or afterwards, you discuss them with a healthcare professional. Signs that may be of concern include blue / grey skin colour, a fast breathing rate, excessive sweating, lethargy, and poor feeding.

Further information

If you would like more information, please speak with your midwife or paediatric / neonatal doctor.