Finding and Treating Fetal Heart Defects

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Fetal Heart Disease

Doctors with Duke University Medical Center's Fetal Cardiology Program can accurately diagnose heart defects before birth with fetal echocardiograpy, a test similar to the ultrasound performed in an obstetrician's office.

"We believe the best care of a child with suspected or known congenital heart disease begins before the child is born," said Piers Barker, M.D. assistant professor of pediatric cardiology at Duke.

About 40,000 babies in the U.S. are born with heart defects each year, according to the March of Dimes. Heart defects are among the most common birth defects and are the leading cause of birth defect-related deaths, the organization says.

A fetal echocardiogram is similar to an obstetrical ultrasound; both use sound waves to create an image of the fetus. However, fetal echocardiography ultrasound is designed to clearly capture pictures of a tiny, fast beating fetal heart. It is painless and non-invasive.

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Early diagnosis of congenital heart defects is important because it allows parents and physicians time to prepare for care after the baby is born, Barker said. In most cases, expectant mothers can continue to see their regular obstetrician, he said. "However, if a fetus has complex congenital heart disease, we often recommend the mother deliver at a tertiary care hospital with immediate access to a level III NICU and pediatric cardiothoracic surgeons," Barker said. A NICU is a neonatal intensive care unit.

At Duke, expectant parents may tour the labor and delivery areas, the NICU, the pediatric cardiac intensive care unit and meet with a surgeon if their child has a heart condition that will require surgery a few days after birth. And for families from rural areas, early diagnosis and planning for birth at a major hospital can prevent disruptions and unnecessary separation.

"Fetal echocardiography really allows families to be more prepared, especially people from rural areas," said Stephen Miller, M.D., a pediatric cardiologist who oversees the Duke Children's cardiology program in Fayetteville, N.C.

With advances in surgical treatment, many children now undergo surgery to repair congenital heart defects before they are one year old. This early care can help prevent the development of additional complications and gives children an earlier start on a normal life, Barker said.

Doctors may recommend fetal echocardiography for pregnant women with a family history of congenital heart defects or known or suspected genetic syndromes. Other common reasons include maternal diabetes or diseases such as lupus and scleroderma, exposure to certain medications and irregular fetal heart rhythms. In the case of fetal arrthymia

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