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Detecting congenital heart failure with prenatal screenings | Wear The Gown

One out of every 100 babies born has this life threatening condition.

SAN ANTONIO — A congenital heart defect is a problem with the structure of a child's heart that is present at, or before birth. 

Here in Texas, congenital heart defects, or CHDs, are only caught before birth one out of four times, making this state one of the lowest prenatal detection rates for CHDs across the country.

"I could tell something was wrong when I went for my ultrasound to do the gender reveal," said Lauren Freeman, who found out her second child, Olivia, had may have a heart problem in her third trimester. Her cardiologist confirmed it was a CHD. She added, "He confirmed that there was a hole in the heart. The pulmonary valve was abnormally large and the valve was missing." 

"There are there are babies born with small holes in their hearts that actually close up on their own and don't require any intervention for those babies," said Dr. Ginnie Abarbanell, who is the Chair in Pediatric Cardiology for University Health and UT Health San Antonio. She says all expecting mothers should have prenatal screenings, especially if they are in high risk groups. Dr. Abarbanell told us, "Specifically, if they have underlying conditions like diabetes, a family history of congenital heart disease, or if there's concerns when the OB takes a look at the heart that way."  

Dr. Abarbanell says there are two types of screenings for congenital heart disease. "When I think about screening for congenital heart disease, I think of prenatal screening for congenital heart disease and postnatal screening for congenital heart disease. So, prenatal screening would be if I'm a pregnant mom, I would have to have prenatal care and an OB would take a look at my baby's heart in-utero. If there are some concerns or that mom had any of those other conditions that we were talking about, then I would be sent over to a pediatric cardiologist like myself, or fetal cardiologist, to take a look at the baby in utero to see if there's a heart defect. The second type of screening is what we call postnatal screening, which is done pretty much everywhere in the United States now. That is checking the oxygen saturation, which is checking the blood level of the baby in the arm and the foot, and comparing those two values to see if there's a problem, and if there is, then we would take into an echocardiogram or ultrasound of the baby's heart after one baby's born to see it."

Shortly after birth, little Olivia had the surgery needed to save her life. Now, she's a healthy baby girl. But, without being screened for a CHD, that may not have been the case. 

Dr. Abarbanell said, "If we can catch them early, the outcome is better, and that's why it's really important to me. We would always encourage all moms to get good prenatal care. Our hope is that our OB colleagues and our maternal fetal medicine colleagues would be picking up if there are any abnormalities on the fetal heart when they do the prenatal ultrasound. If there are abnormalities, then we would hope that those patients would be sent on to us so we can better diagnose what is going on with that baby's heart in order to plan for delivery where babies should be born. All of those kind of things because we know that if we diagnose significant congenital heart disease in utero, and we plan for the delivery, that they have better outcomes at the time of surgery."

For more information on family health call 210-358-3045. You can also find more Wear The Gown stories here.

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