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Newborn CHD Screening — RACP Paediatrics MCQ

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HardNeonatologyNewborn CHD ScreeningRACP Paediatrics

A well term newborn screened after 24 hours has right-hand saturation 94% and foot saturation 95%, with a stable trace and no respiratory signs. What is the appropriate next action in the Queensland pathway?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Repeat pulse oximetry after the pathway interval and reassess the infant

Explanation lettering: B = shown as A · E = shown as B · A = shown as C · C = shown as D · D = shown as E

C is correct because saturations in the intermediate range do not pass solely on a small hand–foot difference; a well baby is re-screened after the pathway interval and clinically reassessed, with persistent abnormality prompting evaluation and delayed discharge. A ignores the absolute saturation criterion. B mistakes a screening result for a diagnosis and overlooks non-cardiac causes. D starts a high-risk treatment without a duct-dependent clinical syndrome or specialist assessment. E creates an unsafe delay and omits the repeat screen. This is more discriminating than the original obvious bilateral 96% pass scenario.

Reference: Queensland Clinical Guideline, newborn pulse oximetry screening for critical congenital heart disease: https://www.health.qld.gov.au/__data/assets/pdf_file/0021/1127613/f-newexam-cchd.pdf