There is no right time to learn that your baby has a heart defect. While great advances have been made in infant heart surgery, there’s no way to prepare for that kind of news. The prognosis, however, can be much better when a diagnosis is made early. The majority of babies with congenital heart defects (defects that develop before birth) get treated and go on to live normal lives. When doctors detect heart defects in the womb, parents have time before their baby is born to understand and accept the situation. Doctors have the information they need to monitor the baby carefully and make plans for the most appropriate care before, at and after the birth. In some cases, mothers can be given medication to treat specific problems, including abnormalities in heart rhythm or function, before birth.
Advanced testing makes early diagnosis possibleWe now have the technology to detect cardiac anomalies in fetuses as early as the second trimester. If we detect a thick nuchal translucency (a collection of fluid under the skin at the back of the baby’s neck) during our first trimester advanced, high-resolution ultrasound, this may indicate the baby is at risk. In that case, we will schedule fetal echocardiography during the second trimester. Magnetic resonance imaging (MRI) and other tools can also give us a detailed look at the baby’s heart. Unfortunately, not all medical practitioners are aware of the availability of these services or consider their patients at risk. Less than half of all congenital heart defects are diagnosed before birth. Therefore, in April of 2014, the American Heart Association published updated guidelines on detecting, managing and treating congenital heart problems in utero in order to promote earlier intervention.
Who is at risk?Congenital heart disease is not that common. Roughly 8 out of every 1,000 babies are born with a heart defect (less than one percent). The majority of congenital heart defects have no known cause. However, there are some situations that put women at increased risk of having a baby with such a defect. These include:
- Having a heart defect yourself
- Having a parent or sibling who was born with a heart defect
- Taking antiseizure medicine during the first trimester
- Taking lithium to treat depression
- Taking painkillers called nonsteroidal anti-inflammatory drugs (NSAIDS) in the third trimester
- Going into a pregnancy with diabetes
- Getting pregnant through IVF
- Having a baby with chromosomal abnormalities, such as Down Syndrome