When you are told your baby has a heart defect
Heart defects are amongst common congenital malformations affecting babies. Heart defects can be seen in 8-9 per 1000 live births. Risk factors for having heart defects in babies include maternal uncontrolled sugars at the time of conception. Mothers on certain anti epilepsy medications like phenytoin or certain anti-hypertensives in the first trimester. Maternal alcohol consumption and morbid obesity (BMI >35 kg/m2) are also strongly linked to babies developing heart defects.
Certain fetal factors like twins with single placenta, babies having other structural defects or increased NT (nuchal translucency) in the first trimester are also at increased risk of having heart defects.
Heart defects can be diagnosed as early as first trimester with transvaginal sonography. However; majority of the heart defects can be seen by 16-17 weeks of gestation. Therefore, by the time of routine anomaly scan at 19-20 weeks in India, most of the severe cardiac defects will be diagnosed conclusively. However; some defects will still prove elusive as they will present only in the third trimester like co-arctation (narrowing) of aorta.
Once a heart defect is diagnosed, usually an invasive test called amniocentesis is ordered to rule out underlying genetic abnormalities. Once the genetic abnormalities are ruled out, further management will depend on the severity. Heart defects can range in severity from very mild (small holes – ventricular septal defects) which will need only follow up and will probably heal spontaneously in the first year to life threatening diagnoses that need immediate surgical intervention. Some maybe be so severe that parents may chose to discontinue the pregnancy.
This differentiation is important as the place and timing of delivery becomes very crucial. Rest of the pregnancy usually goes unaltered. A multidisciplinary team consisting of obstetrician, fetal medicine specialist, pediatric cardiologist and neonataologsit look after the mother and baby.
With superior neonatal medical and surgical expertise and early prenatal diagnosis, many babies with heart defects have a favorable outcome.
Dr. Ashwini Rathi is Director of Mumbai Fetal Medicine Centre, Irla Parimal society, Off Juhu lane. Andheri (W) and a consultant at Surya Mother and Child hospital, Santacruz.
For appointments please call – +91-8669227227.