Description
Fetal cardiology involves diagnosing heart conditions in unborn babies to enable timely intervention and management. Techniques like fetal echocardiography and Doppler ultrasound allow detailed visualization of the fetal heart's structure and function. This non-invasive imaging technique helps identify congenital heart defects, assess blood flow, and guide treatment planning.Fetal cardiology is crucial in pregnancies with maternal diabetes, genetic syndromes, or a family history of heart disease. Fetal cardiologists provide parents with information about the heart condition, prognosis, and available treatment options. Fetal cardiology teams often include obstetricians, neonatologists, geneticists, and pediatric cardiologists to ensure comprehensive care. Some heart conditions can be treated before birth to prevent complications postnatally, such as balloon valvuloplasty for stenotic valves. Fetal Heart Rate Monitoring: Continuous monitoring of the fetal heart rate helps detect irregularities and potential cardiac issues.
Résumé
- Fetal echocardiography is the examination of the fetal heart, ideally performed between 16 and 20 weeks gestation. This is because, while the heartbeat is visible earlier, detailed assessment of intracardiac structures is more reliable after 16 weeks. It is a targeted scan intended to rule out significant congenital heart diseases.
- Congenital heart disease is a common congenital disorder, affecting roughly 1% of live births. Fetal echocardiography is important because it enables early detection, which can significantly improve outcomes, particularly in countries with limited resources. The individual performing the scan should have expertise in fetal cardiovascular anatomy, physiology, and development.
- Indications for fetal echocardiography include maternal, fetal, and familial factors. Maternal factors include pre-gestational diabetes or exposure to teratogenic drugs. Fetal indications include abnormal TIFFA scan findings, extra-cardiac anomalies, suspicion of trisomy, or irregular heart rates. Familial indications include a previous child or parent with congenital heart disease.
- The scan requires high-frequency, high-resolution equipment. It involves assessing the fetal position, visceral situs, cardiac size and axis, and a systematic review of the four-chamber view, outflow tracts, and three-vessel view. Color Doppler is a valuable tool, used after the 2D assessment to confirm findings and assess flow patterns.
- Important congenital heart defects that can be diagnosed include major septal defects, ventricular disproportion, and great artery abnormalities. It is essential to understand normal fetal circulation, such as patent foramen ovale and ductus arteriosus, to avoid misinterpretation. Reporting has to be cautiously done and should avoid inducing unwarranted parental anxiety.
- The outcomes of a fetal echocardiography can vary, from a normal study to the diagnosis of a congenital heart disease. In cases of CHD, the parents should be provided with thorough counseling to make informed decisions. Proper antenatal diagnosis and planning facilitate in-utero transfer to centers with pediatric cardiac care, improving the baby's overall prognosis.
- Current priorities include screening for congenital heart disease during TIFFA scans, followed by targeted fetal echocardiography in cases of suspected abnormalities. Early referral for expert assessment is essential. The overall goal is to improve the outcomes of congenital heart disease by enabling early diagnosis and timely interventions.
Exemple de certificat
À propos des intervenants
Dr Srinath Reddy
Senior Pediatric interventional Cardiologist at Sri Padmavathi Children's Heart center, Tirupathi
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