Although congenital heart disease is considered the most common cause of birth defects in newborns, many parents can be concerned about their baby’s heart health. Many congenital heart disease can be diagnosed early with the fetal echocardiography method, which examines the baby’s heart while it is still in the mother’s womb. In order to intervene in heart disease detected at birth, parents can be referred to appropriate centers and early and correct intervention can be planned. Professor Dr Feyza AyÅenur PaÃ§ from the Pediatric Cardiology Department of Memorial Ankara Hospital gave information on heart problems in babies.
Occurs early in pregnancy
Congenital heart disease (CHD) is a structural disease that occurs early in pregnancy and is found in a baby’s heart. Although these conditions exist from the moment the baby is born, some of them are mild and only require follow-up, while others are more serious and require treatment.
Watch out for the first two months of pregnancy!
The development of babies’ hearts in the womb is 3-8. Takes place between weeks. Developmental defects that may arise during this period can lead to congenital heart disease in infants. However, symptoms may develop during the 2nd and 3rd trimesters of pregnancy related to conditions such as arrhythmias.
Beware of risk increasing factors!
Some problems and illnesses seen in pregnant women can cause abnormalities in their baby’s heart. Factors that increase the risk of a heart defect are:
- Exposure of the mother to certain agents (teratogens), drugs or infections that cause developmental problems in the baby,
- The use of certain drugs and substances,
- Mother’s excessive alcohol consumption
- Maternal rubella, cytomegalovirus infection and exposure to high doses of ionizing radiation during the first trimester of pregnancy,
- Presence of diabetes in the mother (The risk of congenital heart disease increases from 0.6-0.8% to 4-6% in cases where diabetes is not controlled early in the period. This risk ratio is 14% for babies of mothers with phenylketonuria)
- Connective tissue diseases in the mother,
- Have a family history of congenital heart disease, especially in the mother.
With fetal echo, the baby’s heart abnormalities in the womb can be detected
These abnormalities which can develop in the heart of the baby in the womb of the mother can be detected by the ultrasound method, the fetal echocardiography, also called “fetal echo” for short. In this method, information about the structural state and functions of the heart can be obtained through ultrasonic sound waves.
Among the most common anomalies are congenital heart disease.
Congenital heart disease is a disease that occurs during the development of the baby in the mother’s womb. Fetal echocardiography can reveal the results of certain conditions in which the heart is secondary and develops due to non-cardiac factors such as congenital heart disease, various arrhythmias, anemia. While the incidence of coronary heart disease, which is one of the most common birth defects, is between 1% and 2%, the incidence of these diseases in the womb can reach higher levels.
It is a safe method for mother and baby
18-22 weeks of pregnancy is the most suitable time interval for the application of fetal echo. Fetal echocardiography is performed by imaging the baby’s heart using appropriate probes from the mother’s abdominal surface. This procedure, which is a reliable method for the mother and the fetus, is safe. With regard to connective tissue diseases and arrhythmias, it is important to perform this procedure in the 2nd and 3rd trimesters of pregnancy.
It should be applied to high risk groups.
Fetal echocardiography should be applied to high risk groups in order to detect congenital heart disease. Risk groups include people with a positive family history, pregnant women with certain diseases, exposure to teratogens (agents) during pregnancy, intrauterine infections such as rubella, reported fetal abnormalities, amniotic fluid abnormalities, the presence of chromosomal abnormalities, twin pregnancies, monozygotic and Siamese twins. . However, fetal echo can be applied to mothers with abnormal test results as well as older mothers.
The diagnosis affects the course of the disease after birth
Coronary artery disease is one of the most frequently missed abnormalities in prenatal ultrasound studies. The prenatal diagnosis of these diseases considerably affects the course of the patient after birth, especially in certain congenital heart diseases. In addition to ultrasound scans, which are increasing in frequency around the world, there is an increasing demand for fetal heart assessment.
All pregnant women should have fetal ultrasound screening.
Fetal echocardiography is mainly performed in mothers who are in the risk group. However, it was observed that 90 percent of the abnormalities found in routine fetal echocardiography examinations were detected in babies of pregnant women who were at no risk. In other words, just because the mother is not at risk does not mean that her baby will not have coronary artery disease. For this reason, it is important that all pregnant women undergo fetal echocardiography screening.
Many heart conditions are treatable
There are many heart conditions that can be treated today. Treatment options vary depending on the type of abnormality, gestational age, accompanying major abnormalities, and ethical status. In cases where congenital heart disease is detected by fetal echo, an evaluation is made depending on the state of the pathology. In cases where mother and baby need to be followed up, parents are referred to appropriate centers for the necessary intervention at birth. Thus, it is ensured that an early and correct intervention is planned for the baby.
During the fetal ultrasound, families are informed of the possibility of terminating the pregnancy up to week 24 in babies with severe heart disease. In addition, when there is a rhythm disturbance in the fetus, medications given to the mother help regulate the baby’s rhythm.