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How to assess the fetal heart?

3 May 2023

Key points:

  • Early detection of congenital heart disease improves outcomes after treatment.

  • Three stages in the baby’s development allow the diagnosis of congenital heart disease.

  • Surgery and catheterization are two very useful treatments to restore your baby’s heart health.

Heart abnormalities that develop before birth are known as congenital heart disease. Due to this, alterations will occur either in the heart’s structure or in its functioning, since it was not able to form adequately, which conditions babies to have some health problems from birth.

Congenital heart diseases are a series of conditions that are present from birth and include malformations in the heart chambers and valves, as well as in the main vessels that emerge from the heart. In Mexico, each year between 12,000 and 16,000 babies are born with a heart malformation, and it is the main congenital condition registered in the country.1

There are three key moments for the detection of congenital heart disease:

  • Fetal stage. Routine pregnancy check-ups, which take place at weeks 12, 20, and 28, are a good time for your OB/GYN to detect whether your baby is developing properly or whether there is an abnormality.
  • At birth. As soon as the baby is born, the pediatrician can detect warning signs, these may include alterations in the level of oxygen in the blood, nail coloration, tiredness when eating, and sweating, to name a few.
  • During its development. It is possible that some heart disease goes unnoticed during the first stages of your baby’s life and begins to manifest as the child grows.

Although some risk factors could trigger congenital heart disease, in most cases these occur in patients who do not have them, so it is important for the obstetrician and pediatrician to always have good control.

Among the risk factors that are frequently related to the appearance of congenital heart disease is that the mother has lupus or diabetes or that it is detected that the baby will be born with Down syndrome, but you must be aware that having any of these characteristics does not mean that there will be any congenital heart disease.

How can I know if my baby has congenital heart disease?

Depending on your baby’s stage (fetal, neonatal, or early stages of life) the obstetrician or pediatrician may request different tests that confirm or rule out the presence of heart disease, these can be:

  • Fetal cardiac ultrasound: It allows us to study in great detail the anatomy of the baby’s heart from the womb, this procedure works as if it were an ultrasound of the fetus’s heart.
  • Electrocardiogram. Evaluates the heart rhythm or its electrical activity, which allows the detection of arrhythmias and other heart rhythm problems.
  • Chest x-ray. By using a small dose of radiation, it is possible to obtain an image that allows evaluating the size of the baby’s heart and lungs, and knowing if the organ is the correct size.
  • Heart screening. It evaluates the baby’s blood oxygenation level and is performed through the newborn’s hand or foot.

In addition to these tests, both parents and the pediatrician may observe changes in the baby, which may lead to the suspicion of heart disease, these include breathing problems, blue or purple skin, lips or nails, eating very fast, or getting tired when doing so, atypical sweating, frequent infections in the respiratory tract, if they have had pneumonia or frequent infections in the respiratory tract or if they have growth problems.

Similarly, the doctor, when examining the newborn, could perceive the presence of a murmur, which is a noise identified by listening to the heart with a stethoscope. In general terms, the murmur can be “good” or innocent and only happens as a noise caused by the blood flow; but sometimes it can translate into heart disease that must be treated promptly.

How is congenital heart disease cured?

The type of treatment will be indicated once the appropriate tests have been performed and the cardiologist has determined the presence of congenital heart disease and its severity.

Congenital heart disease can be treated through surgery that involves making repairs or corrections within the heart, known as open-heart surgery and which, thanks to current technological advances, is a very successful surgery.

Another way to treat heart disease, depending on its type and needs, is cardiac catheterization, where special instruments known as catheters are used together with other devices, which allow them to navigate through the body’s vessels and treat the condition from inside or outside the heart

There are mild heart diseases, which are the vast majority, and are usually treated with catheterization or surgery; after this, the baby will have an excellent quality of life. But some rare heart diseases are moderately or severely complex, in these cases, the exercise that the child will perform in the future should be supervised, but still, they will be able to lead a proper life.

An early diagnosis allows surgery, when indicated, to be more successful, children spend less time in intensive care, and with fewer complications.

At the ABC Medical Center’s ABC-Kardias Pediatric Heart Center, we can provide you with specialized care. Contact us!

Dr. Moisés Mier Martínez – cardiólogo pediatra del Centro Médico ABC
Dra. Fabiola Pérez Juárez – cardióloga pediatra y ecocardiografísta pediatra del Centro Médico ABC
Dr. Alexis Javier Palacios Macedo Quenot – cirujano cardiólogo pediatra del Centro Médico ABC
Dr. Juan Pablo Sandoval Jones – cardiólogo pediatra del Centro Médico ABC
1 https://www.gob.mx/salud/prensa/072-al-ano-nacen-en-mexico-entre-12-mil-y-16-mil-infantes-con-afecciones-cardiacas

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