Fetal Echo: A window to the unborn heart

One in every 120 children in India are born with a heart defect and about a third of them have serious defects.

Congenital heart defects or birth defects of hearts have emerged a major cause of infant mortality, with other causes like diarrhea and pneumonia having been contained. With advances in ultrasound technology, it is now feasible to diagnose defects of heart during early pregnancy.

Fetal echocardiography is an advanced ultrasound for evaluation of the heart in the unborn child. The ultrasound beam is transmitted through the abdomen and the uterus of the expectant mother and the images of the fetus are recorded using reflected waves. This has been found quite safe to fetus and mother and several examinations can be performed during pregnancy.

"Diagnosis of heart defects before birth has broadened the horizons for treatment of these defects by giving more options to the expectant family. This includes termination of pregnancy in very complex cases if diagnosed in early pregnancy (before 20 weeks) and planned delivery care in critical correctable conditions," said Dr.Balu Vaidyanathan, Clinical Professor in the Department of Paediatric Cardiology and in charge of the foetal cardiology service at AIMS. "Additionally, in selected cases with abnormal fetal heartbeat, it is possible to administer treatment to fetus (in-utero therapy). Fetal echocardiography requires a great deal of expertise and training."

Fetal diagnosis and treatment of congenital heart defects is a very new concept in India and Amrita Institute of Medical Sciences (AIMS), Kochi is one of the few facilities of its kind offering comprehensive diagnosis, counselling, planned delivery and perinatal cardiac care and in-utero therapy in selected cardiac conditions like foetal heart beat variations. Since its inception in 2008, AIMS has performed more than 2,500 fetal echocardiography evaluations and identified around 750 cases with cardiac defects. More than 150 mothers underwent a planned delivery after detection of major heart defects by fetal echo and more than 50 newborn babies thus delivered underwent immediate heart surgery after birth for critical defects with a success rate of 98%.

Experts in the field will meet on December 20-21, 2014 at AIMS to exchange latest information on fetal diagnosis of congenital heart defects and strategies for management of these conditions during the pregnancy stage. They include specialists in prenatal diagnosis like Dr. Ramamurthy (Bangalore), Dr. Indrani Suresh (Chennai), Dr. Nitin Choubal (Mumbai), pediatric cardiologists like Dr. Nageswar Rao (Hyderabad), Dr. Snehal Kulkarni (Mumbai) and Dr. Sejal Shah (Bangalore), besides experts from this field from Kerala and the host faculty. The conference will focus on how to bring this advanced technology to the maximum benefit of patients and improve outcomes in the care of babies with birth defects of the heart.