Help for Infant Hearts

‘Pulse ox’ test now available for newborns at Mary Greeley Medical Center.

Judy Balbiani, R.N., performs a pulse oximetry test on a newborn

Judy Balbiani, R.N., performs a pulse
oximetry test on a newborn at
Mary Greeley’s Birthways Unit.

Congenital heart disease (CHD) is one of the most common birth defects and occurs in nine out of every 1,000 births. But with the help of an easy test now provided at Mary Greeley Medical Center, CHD can be detected as soon as possible.

Referred to as a pulse oximetry test, or a “pulse ox,” the simple, painless procedure measures how much oxygen is in the blood. CHD is a problem in the structure of the heart or its major blood vessels, so low oxygen levels in the blood can be a sign of serious CHD.

Mary Greeley provides this test to every baby prior to discharge, and at no additional cost. Newborns are screened at 24 to 48 hours after birth, and the test is performed by placing a sticky strip, similar to a Band-Aid, on the hand and foot. A normal pulse ox is 95/100 percent. If a test shows an oxygen level lower than that, an echocardiogram, or “echo,” may be ordered to see if there is indeed an issue with the heart.

McFarland Clinic pediatrician Dr. John Paschen is a firm believer in the pulse oximetry test. “This is an excellent tool for us to use in addition to our other methods of screening for this very serious condition and we are proud to offer it here,” he says. “We also have the ability to perform pediatric echoes at Mary Greeley Medical Center and have the full cooperation of the pediatric cardiologist in Des Moines should there be a need to consult on a case.”

Nine states have laws mandating the test on newborns, but Iowa is not one of them. In fact, according to the American Heart Association, only 30 percent of Iowa hospitals offer the test. Mary Greeley Medical Center, which delivers more than 1,000 babies a year at its Birthways unit, is now among them.

Nyla Carswell, B.S.N., director of Maternal Child Services at Mary Greeley Medical Center, is excited about being able to offer the test. “We began hearing about it last spring and learned more about its importance at the National Conference in Washington, D.C. We felt at that point we should be proactive in implementing the test at Mary Greeley to show our commitment to the families we care for,” she says.

Frequently Asked Questions:

What is congenital heart disease (CHD)?

  • CHD is a problem in the structure of the heart or its major blood vessels. It is the most common birth defect.
  • Some forms of CHD are very serious. These can cause a baby to become sick soon after birth.

How do you check for CHD?

  • Before your baby goes home we will check for two things:
    • A sound in the baby’s heart called a heart murmur
    • Abnormal heart rate, breathing or blood pressure
    • We will also do a pulse oximetry test to check for low oxygen levels.

What is pulse oximetry?

  • Pulse oximetry is a simple, painless test that measures how much oxygen is in your baby’s blood. It is sometimes called a ‘pulse ox.’
  • We will place a sticky strip, like a Band-Aid, on your baby’s hand and foot. A small red light on the strip measures your baby’s oxygen level.
  • This will only be on your baby’s skin for a few minutes. It will not hurt your baby.

Why should my baby be checked for CHD?

  • Low oxygen levels can be a sign of serious CHD. If your baby has CHD, this test may tell us BEFORE your baby becomes sick.
  • Low oxygen levels may also occur if:
    • Your baby’s lungs and heart are adjusting after birth
    • Your baby has a problem with their lungs

What is a normal pulse-ox result?

  • A normal reading is 95-100%, with a difference of less than 3 points between the hand and the foot.

What happens if my baby has low oxygen?

  • If the pulse-ox reading is low, we will perform the text again in an hour.
  • If the reading does not improve, an echocardiogram, or ‘echo’ may be ordered. This is an ultrasound of the heart and like the pulse-ox test, it will not hurt your baby.
  • Tests will be shared with the pediatric cardiologist and the results will be reviewed with you before your baby leaves the hospital.



Birthways at Mary Greeley Medical Center is where expectant mothers from throughout central Iowa come to deliver their babies. See why more moms choose Birthways.