PRENATAL DIAGNOSIS AND FETAL THERAPY
Fetal echocardiography provides important information about the structure and function of the fetal heart. With its help, possible structural abnormalities of the heart (CHD), heart rhythm disorders (arrhythmia) and heart function disorders are identified.
Fetal echocardiography may be performed at any time during pregnancy.
The baby’s heart may be examined as early as the 12-th gestational week and some of the severe heart defects may be detected during this early period of pregnancy. Since the foetal heart is very small at 12 weeks, most often the exact diagnosis cannot be made, but if a heart defect is suspected we will recommend an early foetal echocardiogram during the 16-th gestational week. Then the size of the baby’s heart allows a more detailed examination.
Still, the most appropriate time for echocardiography is after the completion of the 20-th-22-nd gestational week. At this point, the heart has reached a large enough size to be examined in detail and a well-prepared specialist would be able to detect about 80% of congenital heart defects.
Modern medicine allows diagnosis of a large proportion of foetal anomalies during intrauterine development. The most common congenital anomalies are congenital heart malformations (CHM). Their detection during pregnancy is by foetal echocardiography, in which the structure and function of the foetal heart are examined by using ultrasound.
At Nadezhda Hospital, fetal echocardiography is performed by the specialists of the Prenatal diagnosis and fetal therapy Department during each fetal anomaly scan. All babies in whom an abnormality is detected are referred to a paediatric cardiologist for consultation.
Some women have a higher risk of congenital heart malformations, and therefore a specialist examination by a paediatric cardiologist is recommended.
The following groups are considered risk groups: cases of CHM in the family (parents or children with CHM), heart rhythm disorders. Even with a normal foetal morphology result, these patients are referred for consultation with a paediatric cardiologist. The risk is also greater with advancing parental age.
Nevertheless, lack of familiarity and known risk factors are present in about 70% of those born with CHM. Therefore, fetal echocardiography is desirable in every pregnant woman.
It is advisable that foetal echocardiography be performed around the 20th gestational week (between 18-th and 22-nd gestational week).
Fetal echocardiography identifies structural abnormalities of the heart (CHM), abnormal heart rhythms (arrhythmias) and cardiac function abnormalities.
It is vital for the foetus to establish and comprehensively specify foetal haemodynamics and the maternal-foetal-blood circulation relationship to and from the placenta, umbilical cord, etc.
Unfortunately, some cardiac abnormalities, such as mild valvular lesions, small ventricular or atrial septal defects, etc., may not be detected prenatally.
Fetal echocardiography provides important information and forms the basis for establishing management and further detailed evaluation of the infant’s heart after birth. When a CHM is detected, the parents, the paediatric cardiologist and the gynaecologist discuss the outlook and outcome of the pregnancy. In these cases, the planning the site and mode of delivery is particularly important, in case of a pending cardiac surgery.