In this episode of Healthful Woman podcast, Dr. Nathan Fox, OB-GYN and maternal-fetal medicine specialist practicing in New York City speaks with Dr. Miwa Geiger, associate professor of pediatrics and cardiology and director of the Fetal Heart Program at Mount Sinai regarding congenital heart disease in newborns.
Congenital heart disease is described as one or more problems with the heart’s structure that exist since birth. There are many different types of congenital heart defects that can affect babies. In many cases, congenital heart disease may be suspected during a routine ultrasound scan of the baby in the womb. A special ultrasound called fetal echocardiography can then be completed at about 18-22 weeks to confirm a diagnosis.
“Initially, the things that get picked up prenatally are the obvious things that are just like the heart is really different than normal, and then there’s other defects or subtle abnormalities that we may not even pick up by fetal echo,” said Dr. Geiger. “Holes in the heart are sort of the most detected abnormality. And then the other thing that’s common but not always detected is something called bicuspid aortic valve and you have two aortic valve leaflets functionally instead of three. So those are the kind of most common things, and those are the things that actually don’t always get detected by fetal echo.”
When a woman finds out that her baby may have heart issues, she often wants to know what that means regarding surgery, as well as what her child’s future looks like. Sometimes, that can be hard to detect, as different people may have different outcomes with the same conditions. Babies with medium or severe defects often need to undergo surgery to correct the issue.
“Tetralogy of Fallot, AV canal, I would say those are… You may need one surgery, but you may need tune-ups kind of,” explained Dr. Geiger. “Sometimes if you have Tetralogy of Fallot, you have your initial surgery, but then you might need pulmonary valve replacements every 10 to 15 years. And then there are the more severe categories where they probably don’t have one of the pumping chambers adequately sized, or their valves are situated in a way that we can’t have the blood flow going to the correct pumping chamber. And so those babies these days are now doing better and better. But still, those patients I would say have more limitations. They have long-term complications usually by their 20s or 30s. Some of them will need heart transplants by the time they’re adults, occasionally as teenagers.”
For families that find out that their baby will need to have surgery before going home from the hospital after being born, they will need to meet with a heart surgeon to discuss their options. They can also discuss the many other heart specialists that their child may need to see, including a cardiologist, interventional cardiologist, pediatric surgeon, and more. Over time, important discussions of what to expect and what procedures are best for their child will be needed.
Maternal Fetal Medicine blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!