Congenital heart defects, coronary artery disease, are the most common type of birth defect and are present in about 1% of newborn babies. The term refers to more than a dozen structural irregularities that can affect how blood flows through the heart and body.
One of the most common coronary heart diseases is an atrial septal defect, often referred to as a hole in the heart. The heart valves, arteries, veins and chambers can also be distorted, affecting the baby’s circulation.
About one in four babies with coronary heart disease will need surgery in the first year of life, but the defect can usually be successfully treated if caught early.
Dr. Ginnie Abarbanell, chair of pediatric cardiology for University Health and UT Health San Antonio, is a strong advocate for prenatal cardiac screenings, especially for high-risk babies. Dr. Abarbanell said a 2015 study found that only 24% of Texas babies with coronary artery disease had prenatal screenings that help doctors prepare for treatment at birth.
“This is one of the lowest prenatal detection rates for congenital heart disease (in the country),” Dr. Abarbanell said. “There are a lot of factors that are tied to that. I think one has to do with the vastness of Texas. Prenatal care varies by location. I think the detection rate is probably improving a bit , as our OB (obstetrician) colleagues put in place different guidelines on how to examine the fetal heart and when to refer these mothers for further evaluation.”
Which mothers and their unborn babies need prenatal heart screening the most?
We recommend that moms have a fetal echocardiogram to examine their baby’s heart if:
- they had diabetes before they got pregnant
- there is a family history of a heart defect
- the mother has already had a child born with congenital heart disease
There is also a link between congenital heart disease and IVF (in vitro fertilization).
If the fetal heart cannot be seen well by the OBGYN during your prenatal ultrasound, we recommend that you do this as well.
If I have one of the risk factors, how do I make sure my baby and I get the prenatal screening we need for coronary heart disease screening and treatment?
Ask your obstetrician, “Do I need to have my baby’s heart checked more closely because of risk factors?” Then ask your doctor, “Did you see the heart well on the prenatal ultrasound?” If not, say, “Let’s make sure we can see the heart, so we can make sure it looks normal.
Where does the process of prenatal screening for heart defects begin?
First, we encourage all moms to get good prenatal care. And we hope that our colleagues in obstetrics and maternal-fetal medicine will detect any abnormalities of the fetal heart during prenatal ultrasound.
If there are abnormalities, we hope that these patients will be referred to us (pediatric cardiologists) so that we can better diagnose what is going on with this baby’s heart in order to plan the delivery.
What should parents expect if a prenatal screening detects a heart defect?
Most babies who are diagnosed with congenital heart disease in the United States today have a very good survival outcome.
About 25% of these children will need heart surgery in their first year of life. These days we have treatments and surgeries that fix congenital heart defects in a fairly safe process, and we’re seeing some of these kids grow up where we didn’t before.
I know if we can catch them early the result is better. That’s why prenatal screening is really important to me.