New Guidelines to Find Heart Problems in Unborn Babies

AHA issues guidelines on diagnosis and treatment of fetal heart disease

(RxWiki News) New guidelines for healthcare providers may give unborn babies a chance at earlier diagnosis and treatment of heart problems.

Even with new technologies to detect heart issues, most heart problems aren’t found until a baby is born. The American Heart Association created new guidelines for testing babies at risk of heart disease while they are still in the womb.

The new guidelines recommended heart testing for fetuses with certain risk factors. These guidelines also addressed the effects on and needs of families with a baby diagnosed with heart disease.

"See an obstetrician for prenatal care."

A team of experts worked on behalf of the American Heart Association Adults with Congenital Heart Disease Joint Committee of the Council of Cardiovascular Disease in the Young and Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and Council on Cardiovascular and Stroke Nursing to create new guidelines for finding and treating heart problems in unborn babies.

Mary T. Donofrio, MD, director of the Fetal Heart Program and Critical Care Delivery Service at Children’s National Medical Center in Washington, DC, was the lead author of the guidelines.

Advances in technology that include three- and four-dimensional heart imaging, echocardiograms that use sound waves to image the heart, magnetic resonance imaging (MRI) and new ways to measure heart function have all created new opportunities to diagnose heart disease in unborn babies.

The new guidelines written by the panel of experts created a set of standard recommendations for situations in which fetal heart testing was advised. The guidelines are intended to be used by many different types of healthcare professionals involved in the prenatal (before birth) care of a baby.

The panel made 27 recommendations that covered fetal heart evaluation, testing, therapy and special delivery room care for infants born with heart problems.

Among the recommendations were heart evaluation by echocardiography for unborn babies if the mother:

  • had diabetes before pregnancy or was diagnosed in the first three months of pregnancy.
  • had a relative with heart disease.
  • used over-the-counter anti-inflammatory medications during the last three months of pregnancy.
  • had rubella, a type of measles, during the first three months of pregnancy.

Fetuses that were known to have a genetic problem or heart problem seen on ultrasound were also recommended to have an echocardiogram.

The guidelines included standards for the way fetal echocardiograms should be performed and specialized therapies recommended based on the results. Some fetal heart problems may be treated by giving medication to the pregnant mother. In some cases, the baby might need surgery to treat the heart problem.

Consideration of other testing that might be needed, such as genetic counseling and family counseling, was also among the recommendations.

In a press statement, Dr. Donofrio explained that even though new technology makes it easier to find fetal heart problems, "more than half of babies with congenital heart disease go undiagnosed before birth."

"We created these guidelines to provide pediatric cardiologists, obstetricians, maternal fetal specialists, radiologists, nurses and other healthcare providers with the latest developments in the rapidly developing area of fetal cardiology," she said.

These guidelines — a scientific statement from the American Heart Association — were published April 24 in Circulation.

Review Date: 
April 23, 2014