But before she could leave the hospital, Jovie had to undergo a screening test that recently became mandatory for all newborns in the state of North Carolina—pulse oximetry to measure the amount of oxygen in her blood.
The simple, noninvasive test known as “pulse ox,” which involves taping sensors on the hand and foot, became part of standard protocol in North Carolina in 2013 after a grassroots effort by parents and doctors who argued it would save lives by uncovering congenital heart defects.
“It looks at differences in [oxygen] saturation that could be caused by various forms of congenital heart disease, and it’s a way to detect these before they would make the baby sick,” said Dr. Rene Herlong, a pediatric cardiologist at Carolinas HealthCare System’s Levine Children’s Hospital.
The sensors were familiar to Jovie’s mom, Bonnie Smith, who had used similar ones in her job as a veterinary technician.
“That’s not normal,” Smith thought.
The hospital nurse repeated the test, using a different machine, and Jovie’s oxygen saturation again read 91 percent—not alarmingly low, but low, and a sign that Jovie couldn’t go home just yet.
As it turned out, Jovie had a congenital heart defect and needed surgery.
In the first day of Jovie’s life, she had no symptoms of a heart disorder, says Dr. Gonzalo Wallis, a pediatric cardiologist at the hospital,where Jovie was treated.
Said Smith, “You never would have known anything was wrong with her.”
But after the low pulse-ox readings, Jovie underwent examinations and an echocardiogram, which revealed she had coarctation of the aorta, or a narrowing of the major artery that carries blood to the body. In addition, the left side of Jovie’s heart was mildly hypoplastic, or underdeveloped, which affects blood flow.
At 1 week old, Jovie had surgery to remove the narrow section of her aorta and sew together the two good ends, Bonnie said. Doctors also closed the ductus arteriosus, an opening that usually closes within two weeks after birth; Jovie’s had not closed and actually helped keep her stable prior to the discovery of her heart defect by bypassing the aorta with oxygenated blood, Smith said.
Doctors monitored Jovie’s heart to make sure the smaller ventricle could handle the new volume of blood, Dr. Wallis said.
“I think she’s going to have a great prognosis,” Dr. Wallis said. “I think she’s going to do very well.”
Without the pulse ox test, Jovie likely would have developed significant heart failure later in life, Dr. Wallis said.
“It was a time saver and potentially life saving for this kid, who had surgical repair in a timely manner before she left the hospital,” Dr. Wallis said. “She definitely could have had a complication. Kids like this could go into early heart failure and get really sick.”
Bonnie has no doubt that the pulse ox test saved Jovie’s life.
The pulse ox law in North Carolina—one of more than 35 states that currently have pulse ox screening requirements—was not in place when the Smiths had their first two children, daughters who are now 6 and 2.
“I told my husband we are so lucky that they were OK,” Smith said. “Bad things would’ve happened (to Jovie) if that law hadn’t been in place.”
The American Heart Association advocates for pulse ox screening for all newborns.
The test not only aids in detection, but yields better prognoses for those who do have heart defects, because early detection leads to better results, said Dr. Herlong.
All that from a simple, inexpensive test.
“There’s no pain involved whatsoever,” Dr. Herlong said, “and it only takes a few minutes.”
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