Feature | May 16, 2014

New guidelines Aim to Improve Care for Babies With Heart Problems in the Womb

American Heart Assn. Statement Babies Congenital Heart

May 16, 2014 — Fetal heart experts working with the American Heart Assn. have developed guidelines to help healthcare providers care for unborn babies with heart problems, as well as their families.

The statement, Diagnosis and Treatment of Fetal Cardiac Disease, is published in the American Heart Assn. journal, Circulation.

"Congenital heart disease is the most common birth defect that can result in either death or significant health problems in newborn babies," said Mary T. Donofrio, M.D., lead writer of the statement, and director of the Fetal Heart Program and Critical Care Delivery Service at Children's National Medical Center, in Washington, D.C.

Fetal care is no longer solely the realm of high-risk obstetricians and neonatologists. A multidisciplinary specialty of fetal cardiology has emerged, according to the statement.

"We now have advanced imaging technologies, such as high-resolution ultrasound and three- and four-dimensional echocardiography, magnetic resonance imaging, fetal electrocardiography and magnetocardiography enabling physicians to diagnose fetal abnormalities early and with better detail and accuracy,” she said.

"Despite this, more than half of babies with congenital heart disease go undiagnosed before birth," she said. "We created these guidelines to provide pediatric cardiologists, obstetricians, maternal fetal specialists, radiologists, nurses and other healthcare providers with the latest developments in the rapidly developing area of fetal cardiology," Donofrio said.

Among the recommendations in the statement:

  • Pregnant women with specific risk factors should be referred for fetal echocardiography, a technology that uses sound waves to examine the fetal heart. Women at risk include those who have had diabetes before pregnancy, diabetes diagnosed in the first trimester, have taken NSAIDs in their third trimester, have congenital heart disease or a close relative with congenital heart disease, or other specific maternal medical conditions, and possibly those who conceived with in vitro fertilization. Fetuses at risk include those identified with a chromosome problem or other abnormality, or those with a suspected heart problem. Fetuses diagnosed with a heart abnormality should be carefully monitored and healthcare providers should plan the delivery and post-delivery care that the baby will need.
  • Some fetal heart rhythm disturbances or heart function abnormalities can be treated with medicines given to the mother, which cross the placenta to reach the fetus. In-utero heart catheterization and surgical procedures are being performed, however are still considered experimental.

The psychological effects and depression that may result when a pregnant woman and her family learns that their child has a congenital heart abnormality are also important factors for healthcare providers to consider. Parents often grieve upon learning that their unborn baby has a congenital heart condition. The authors note that it's important for providers to offer families information in an unbiased way, which not only addresses the condition and what is involved in treatment, but also whether children will be able to play sports, do well in school, and what kind of support they might need, physically and mentally. In addition, providers should help families overcome anxiety and depression, so they can transition from grief to acceptance and become active members of the team that care for their baby.

"This document transcends specialties and gives all healthcare providers that practice fetal cardiac medicine a standard for practice. This means improved care for babies with congenital heart disease, starting in the womb and continuing after delivery and through their lives," said Donofrio.

For information: www.heart.org, www.strokeassociation.org

Related Content

pregnant women, congenital heart disease, new recommendations, Circulation journal, UCLA
News | Womens Healthcare| February 16, 2017
February 16, 2017 — New recommendations for healthcare providers, published in the American Heart Association journal
University of Alabama at Birmingham, Amplatzer PFO Occluder, first implementation
News | Structural Heart Occluders| February 15, 2017
Doctors at the University of Alabama at Birmingham have implemented the first U.S. Food and Drug Administration (FDA)-...
Sponsored Content | Videos | 3-D Printing| February 09, 2017
When a pediatric patient at Children’s Hospital Los Angeles needed a custom-build stent to repair his pulmonary arter
Amplatzer PFO Occluder, St. Jude Medical, Baylor Heart and Vascular Services, Fort Worth, Texas, first patients
News | Structural Heart Occluders| February 01, 2017
Baylor Heart and Vascular Services at Fort Worth in November became the first program in Texas to implant the Amplatzer...
Jaheim Whigham, Lurie Children's Hospital of Chicago, Syncardia 50cc Total Artificial Heart, youngest patient

At 11 years old, Jaheim Whigham (center) is the youngest and smallest patient to receive the 50cc SynCardia temporary Total Artificial Heart. (Photo: Jan Terry, Ann & Robert H. Lurie Children's Hospital of Chicago)

News | Congenital Heart| January 31, 2017
To save the life of an 11-year-old boy, Ann & Robert H. Lurie Children’s Hospital of Chicago has become the first...
congenital heart disease, CHSD, Society of Thoracic Surgeons, public reporting, parent preferences
News | Congenital Heart| January 25, 2017
Survival statistics, surgeon-specific experience and complication rates are the types of information most wanted by...
NCDR, ACC, JACC, American College of Cardiology, national trends, heart disease treatments, trends in cardiovascular care
News | Cath Lab| January 23, 2017
January 23, 2017 — Over 93 percent of heart attack patients are receiving stents within the guideline-recommended thr
3-D echocardiography, ASE/EACVI guidelines, congenital heart disease, CHD, Journal of the American Society of Echocardiography, JASE
News | Cardiovascular Ultrasound| January 20, 2017
January 20, 2017 — A new document from the European Association of Cardiovascular Imaging (EACVI) and the American So
extremely premature newborns, patent ductus arteriosus, PDA, hole in the heart, nonsurgical repair, catheter-based intervention
News | Congenital Heart| January 04, 2017
A new minimally invasive technique for repairing the most common cardiac birth defect in extremely premature newborns...
TeraRecon, WhiteClouds, 3-D printing, 3D Print Packs, RSNA 2016
Technology | 3-D Printing| November 16, 2016
TeraRecon, together with full-color 3-D printing cloud provider WhiteClouds, announced new technological and workflow...
Overlay Init