I am 20 weeks pregnant, have a history of congenital heart disease, so I want to screen my baby. Is my child at risk of this disease? When is the right time to get screened? (Minh Ngoc, 26 years old, Ha Nam)
Reply:
Congenital heart defects are structural abnormalities of the heart muscle, heart valves, septum in the heart and heart rhythm disorders. The disease occurs in the fetus and persists after birth, even into adulthood. This defect accounts for nearly 1% of children born, and is one of the leading causes of death in children.
Screening for congenital heart disease should be performed early in pregnancy and recommended for all pregnant women. Pregnancy is at high risk when the pregnant woman has congenital heart disease or other genetic diseases, gestational diabetes, lupus erythematosus, or hypertension. During pregnancy, the mother is infected with rubella virus, coxsackie virus, parvovirus; Use of anticonvulsants and antidepressants also needs to be screened. In cases where it is necessary to screen for fetal growth retardation, increased nuchal translucency, umbilical hernia, irregular heartbeat, hydrops fetalis not due to genetic factors, risk of twin-to-twin transfusion syndrome…
Fetal echocardiography from 18-22 weeks of age helps detect most heart defects. 2D, 3D and 4D ultrasound techniques allow for accurate assessment of abnormalities in the structure and function of the fetal heart, and diagnosis of fetal heart rate abnormalities.
Early diagnosis at this stage helps promptly treat a number of diseases that can be intervened in the fetus such as severe arrhythmias, severe aortic valve stenosis, severe pulmonary valve stenosis… increasing the chance of survival. for children. The doctor also makes a prenatal plan so that the family can be best prepared.
However, some mild congenital heart diseases such as small foramen ventricular septal defect, atrial septal defect, and patent ductus arteriosus have just been diagnosed after birth. Therefore, children still need to be screened for congenital heart disease during normal pregnancy. Parents need to be more vigilant if they are underweight, premature, fussy, have short feedings, have purple lips, purple extremities, frequently breathe rapidly, gain weight poorly, or have recurrent pneumonia.
There are many methods to help screen and detect congenital heart disease in the postnatal period such as measuring transcutaneous oxygen saturation SpO2, electrocardiography, flat chest X-ray, echocardiography, cardiac magnetic resonance… Doctors only Determine the list of examinations depending on the baby’s age, physical condition and risk factors.
Congenital heart disease is often detected early in children. However, many cases are detected late in adulthood, especially with congenital defects such as atrial septal defect, ventricular septal defect, patent ductus arteriosus, tetralogy of Fallot, coarctation of the aorta…
If not detected and treated promptly, the disease can cause complications such as arrhythmia, heart failure, stroke, and death. Therefore, do not be subjective and listen to your body. People with any abnormalities such as fatigue, difficulty breathing, chest tightness, persistent dry cough, palpitations, dizziness… need to see a cardiologist soon.
Congenital heart disease is a genetic disease. If you have congenital heart disease, your child has a 2-4% increased risk of having the disease. During pregnancy, you should closely monitor your health status with your obstetrician and cardiologist.
20 weeks pregnant is the right time to have an echocardiogram for the fetus. You should choose a medical facility with close coordination between obstetrics and gynecology and cardiology for examinations to help your pregnancy be safe and healthy.