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Case Reports
. 2023 Jun;57(2):148-155.
doi: 10.4314/gmj.v57i2.10.

Cardiovascular physical examination as a screening tool for congenital heart disease in newborns at a teaching hospital in Ghana

Frank Owusu-Sekyere  1 , Bamenla Goka  2 , Della Adzosii  1 , William Obeng  1 , Alfred Yawson  3 , Nana Akyaa-Yao  4 , Sybil Harrison  5 , Justice Moses K Aheto  3
Affiliations
Case Reports

Cardiovascular physical examination as a screening tool for congenital heart disease in newborns at a teaching hospital in Ghana

Frank Owusu-Sekyere et al. Ghana Med J. 2023 Jun.

Abstract

Objectives: To determine the usefulness of cardiovascular physical examination (CPE) as a screening tool in a low-resource setting for detecting congenital heart disease (CHD) in newborns delivered at the Maternity Unit of Korle Bu Teaching Hospital (KBTH), Accra, Ghana.

Design: A hospital-based cross-sectional study with a comparison group component.

Setting: Maternity Unit of the KBTH, Accra, Ghana.

Participants: Over eight months, newborns aged 1-14 days delivered at ≥ 34 weeks' gestation at the Maternity Unit, KBTH, were recruited into the study.

Intervention: Each newborn was examined using a set of CPE parameters for the presence of congenital heart disease. Those with suggestive features of CHD had a confirmatory echocardiogram test.

Main outcome measure: Abnormal CPE features and their corresponding echocardiogram findings.

Results: A total of 1607 were screened, with 52 newborns showing signs of CHD on CPE, of which 20 newborns were proven on echocardiogram to have congenital heart disease. Abnormal CPE parameter that was associated with CHD was murmur (P=0.001), dysmorphism (p=0.01), newborns with chest recessions (p=0.01) and lethargy (p=0.02). CPE's sensitivity, specificity, and positive and negative predictive values were 95%, 60.7%, 36.5% and 98,1%, respectively. The most common acyanotic CHD found was isolated atrial septal defect (ASD), followed by patent ductus arteriosus (PDA). The only cyanotic CHD found was a case of tricuspid atresia.

Conclusion: Cardiovascular physical examination at birth is an effective and inexpensive screening tool for detecting CHD in newborns, which can easily be utilised in low-resource settings.

Funding: None declared.

Keywords: Congenital heart disease; Korle Bu Teaching Hospital; cardiovascular physical examination; newborns; screening tool.

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Conflict of interest statement

Conflict of interest: None declared

Figures

Figure 1
Figure 1
The recruitment procedure and final samples used in this study. NICU=Neonatal Intensive Care Unit
See this image and copyright information in PMC

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