Today is a world heart day. It is celebrated annually to raise awareness about cardiovascular disease and promote heart – healthy habits. Every year world heart day is celebrated on 29th September. Most of the times priority is given for adults cardiac issues. This heart day the theme is “Use heart , know Heart’. A lot many people are unaware of the cardiac issues in children. Congenital heart defects means defects present by birth . The incidence of congenital heart defects is around 8-9/1000 in the general population. In India, approximately 200,000 children are born with heart disease every year, and out of these, about 40,000 children require urgent cardiac procedures within their first year of life. Additionally, many patients who go undiagnosed develop lower respiratory tract infections, severe cyanosis, and breathing difficulties, all of which are life-threatening events. Sudden infant death can occur in some babies with congenital heart defects.
The idea of fetal echocardiography is welcomed as a means to detect life-threatening congenital heart defects in utero. Fetal echocardiography is a specialized sonography technique performed on an unborn baby while it is still inside the mother’s womb to assess the fetal heart. This non-invasive procedure uses sonographic waves to create an image of the heart on a monitor and is typically performed by a pediatric cardiologist. Ideally, it should be done between 18 and 22 weeks of gestation. It provides a clear view of the development of heart chambers, blood vessels, holes, and the heartbeat. Almost 80% of critical heart diseases can be identified during a fetal scan.
With advanced surgical skills, most heart diseases can now be treated. Fetal echocardiography allows for early diagnosis and planning for medical or surgical treatment. At our center, we typically perform around 2,400 fetal echocardiograms each year, making us one of the highest-performing centers.
Fetal echocardiography offers several benefits:
- Early Detection of Heart Defects: Heart defects can be diagnosed as early as 18-20 weeks, enabling the planning of adequate care for the baby in utero and at the time of delivery.
- Treatment Planning: Early diagnosis allows doctors to plan the appropriate treatment. Collaboration with obstetric doctors ensures that treatment can be given, and the team can be adequately prepared.
- Parental Counselling: Parents have ample time to understand the condition, prepare psychologically and financially, and receive adequate support. It eliminates surprises, and the baby can be delivered close to a cardiac center. Many insurance companies now offer coverage for birth defects.
- Better Outcomes: Scientifically, early diagnosis and timely treatment significantly improve a child’s outcome without complications, reducing the financial burden on the family due to a quicker recovery. Newborns often develop complications when CHD diagnosis is delayed. Many babies diagnosed prenatally have undergone successful surgery and thrived. Heart conditions such as ventricular septal defect, atrial septal defect/PDA, tetralogy of Fallot, transposition of great arteries, total anomalous pulmonary venous connection, coarctation of the aorta, aortic stenosis, pulmonary stenosis, double outlet ventricle, and more can now be completely or satisfactorily treated.
Families often wonder if treatment can be provided to the fetus while it is still in the mother’s womb. With advanced technology, in-utero treatment can be offered to babies with CHD in certain conditions. We were the first in India to provide such therapy and have saved many babies.
In conclusion, fetal echocardiography plays a critical role in ensuring the well-being of fetuses with heart ailments, providing the best possible care from the moment of birth. Families sometimes consider CHD a taboo subject and hesitate to seek treatment. However, many children who successfully underwent surgery for heart defects have gone on to become doctors, engineers, teachers, health workers, and intellectually gifted individuals. They serve as inspiring examples and real fighters in our society .
Dr. SHWETA NATHANI BAKHRU, MBBS,DNB Pediatrics, FNB( Pediatric Cardiology)
Senior Consultant - Pediatric Cardiology
Rainbow Children’s Heart Institute, Banjara Hills, Hyderabad.
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