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The Fetal Heart

How does a fetal heart scan differ from a routine pregnancy Scan?
During the routine pregnancy scan only a limited view of the hear is obtained. A dedicated fetal heart scan involves obtaining several views of the heart looking at it from different angles. A Fetal Heart Specialist will also be involved if the examination shows an abnormality.

Who requires a fetal heart scan?
Anyone noted to have a definite abnormality of the heart during a routine pregnancy scan.

When clear views of the heart are not obtained on the routine pregnancy scan.

Parents who already have a child with a major congenital cardiac problem. (There is a slightly increased risk compared to the general population but the scan is mainly done for reassurance in the majority of cases).

Mothers or fathers who themselves have a major congenital heart problem.

When the fetus is known to have other abnormalities that may be associated with heart defects. e.g. Down’s syndrome.

When the fetus is found to have an abnormally fast or an abnormally slow heart rhythm.

Can all congenital heart problems be identified on a detailed fetal heart scan?
Most major cardiac abnormalities can be detected on a detailed fetal heart scan. For example the scan may show that one of the heart chambers is not developed or that one of the blood vessels is absent or significantly narrow. Because of the quality of the pictures and because of the way the fetal heart works before birth it may not be possible to detect small or medium sized holes in the heart and mild or moderate valve narrowing. The heart is continuing to develop during pregnancy and some defects may gradually evolve during the course of the pregnancy.

What happens if a heart abnormality is found?
The nature of the problem, the treatment that may be required after birth and the general long term outlook will be explained to you by a Children’s Heart Specialist who will be looking after your baby after birth. In a few cases heart problems may be associated with chromosomal problems and the opportunity to have a test (amniocentesis) to determine this will be discussed.

Treatment
Treatment depends on which part of the heart is affected. Some children will not need treatment if the effect on blood flow is minor, while others will require medication or intervention such as cardiac catheterization or surgery. Many heart defects can be successfully managed, often in early infancy . Some defects aren’t treated right away, but can wait until the child is older. And some defects are treated in stages. While some heart defects generally aren’t curable, they can be managed well enough to enable the child to function well.

With advances in technology and our understanding of heart defects, the outlook for most children is positive. The risk of serious side effects and complications from treatment is much lower than it used to be. The majority of children will reach adulthood. Children with more complex conditions may face more challenges.

The optimum place for delivering the baby (Southampton versus the local hospital) will be discussed with you. Some families may wish to consider the option of termination if a major abnormality of the heart is detected in early pregnancy. The Fetal Medicine Nurse Specialist who will be present during the scan will provide you with general advice and will be readily contactable for on-going support after you go home.

The Children’s Cardiac Liaison Nurses
Are highly experienced in supporting parents whose children are having treatment for heart conditions and are a valuable source of information and support for parents whose unborn child has been diagnosed with a heart abnormality.

They have first hand experience of the emotional strain parents experience when their children are having major surgery, together with coping with the practical issues of everyday life.

They will be happy to talk to you about any of these issues, together with arranging a visit to the children’s heart ward Ocean E1.

Cardiac Liaison Nurses Contact No Tel: (023 8079 4659)