Fetal Echocardiography - Testing the Heart
An interview with Nikola Tede, M.D., Director of Pediatric Cardiology, and Sarina Behera, M.D. and Ellen Chan, M.D., Pediatric Cardiologists, Sutter Pacific Medical Foundation
Of all birth defects, congenital heart disease is the most common. In fact, nearly one in 100 babies has some form of the condition. While in the past, children with heart problems were sure to face challenging health issues, physicians today can ensure that they not only survive but flourish. Because early diagnosis can help, doctors are now using what’s called fetal echocardiography to uncover heart conditions in utero.
The Risk Factors
Congenital heart defects occur when a fetus’ heart develops incompletely or abnormally during the early weeks of pregnancy. With fetal echocardiography, physicians and technicians use ultrasound images to confirm that a heart is developing normally—that it has four chambers, and blood is properly flowing through them and out the two major arteries. The test usually occurs between the 18th and 24th week of pregnancy.
"Fetal echocardiography is not needed by everyone, only women who might be at risk," says Sarina Behera, M.D., FAAP, FACC. Doctors may recommend one to women who have lupus, diabetes, or thyroid disease, families who have a history of congenital heart disease, or pregnant women who are taking certain medications.
"Women who have had fertility treatment, like in-vitro fertilization, are also candidates for fetal echocardiography," adds Nikola Tede, M.D., FAAP, FACC, "since children conceived through IVF may have an increased risk of a congenital heart defect."
Doctors may also order an echocardiogram if they detect certain fetal conditions, like arrhythmia, chromosomal anomalies, single umbilical artery, increased nuchal translucency, or twin-twin transfusion syndrome.
Preparing for Birth
With the exception of rare cases, doctors use the information from echocardiography, not to do interventions in utero, but to help families prepare for the delivery and treatment of their child. “It decreases the stress related to an unplanned diagnosis after the infant is born,” says Behera.
"In order for nurses and doctors to take care of children with heart disease, it’s important to have birth plans," Tede explains. Some families that had been planning on a home delivery, for instance, may make a different choice. They may instead opt for a hospital that has a high-level newborn intensive care unit (NICU).
An Optimistic Prognosis
The good news is that successful interventions are available for many babies diagnosed with heart defects. Cardiologists can help a child’s heart function better through surgery or cardiac catheterization. The latter is a less invasive procedure, in which doctors use thin plastic tubes threaded through blood vessels to treat heart problems.
While some cases require intervention, others need only regular observation. Through close monitoring, doctors can make sure a child’s blood supply is stable and that he or she is breathing properly and meeting his or her growth parameters.
"In this day and age, babies born with heart defects can lead longer healthy and productive lives,” Tede assures.
About CPMC Pediatric Services
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