Screening for Congenital Heart Disease

By Guest Blogger Michael J. Walsh, MD, assistant professor and pediatric cardiologist, Wake Forest Baptist Health Brenner Children’s Hospital

Congenital heart defects are the most common birth defects, and they affect about 1 in 100 babies. That is why screening measures are common before and after birth.

Types of Congenital Heart Defects

Congenital heart defects are present at birth. There are many different kinds, and they range in severity. On one hand there are minor valve deformities and small holes between the pumping chambers of the heart. Patients with these problems can often live normal lives—without the need for medical or surgical help.

On the other hand, there are congenital heart defects that can make babies sick shortly after they are born. About 25 percent of congenital heart defects are considered “critical.” They are serious enough to require a procedure—often surgery—within the first 6 months of life.

Evidence suggests that earlier diagnosis improves outcomes, so health care professionals are taking a more proactive approach toward screening for defects. This helps us – and families – prepare for the birth of these vulnerable babies.

Prenatal Screening

Prenatal screening for heart defects centers around fetal echocardiography. These are ultrasounds that look at the baby’s heart and larger blood vessels. Most expecting moms will have standard ultrasounds to examine their baby’s anatomy around 20 weeks. However, some moms will require a higher level of screening.

If an obstetrician or nurse midwife sees something concerning during an anatomy scan, they may refer the expecting mom to a pediatric cardiologist for a fetal echocardiography. They may also suggest additional screening if the mom has one or more of these risk factors:

• Family history of congenital heart disease
• Taking certain medicines that make heart defects more likely
• Personal history of diabetes—either type 1 or type 2
• Personal history of certain genetic illnesses
• Heavy alcohol use early in pregnancy
• Certain genetic syndromes or non-heart issues with the baby, such as Down Syndrome or abnormalities in the kidneys, abdominal wall or brain

Postnatal Screening

In recent years, postnatal screening for congenital heart defects has become more common. In fact, a few years ago, it became state law in North Carolina that all babies receive this screening before leaving the hospital.

We perform postnatal screening through a noninvasive pulse oximetry test. A painless sensor is placed on the baby’s toe for a few minutes, and measures oxygen levels in the blood. If the levels are too low, we further investigate problems the baby may have.

This kind of screening is essential because it helps ensure that babies don’t leave the hospital with severe congenital heart disease. And since babies with heart defects often don’t show visible symptoms right after birth, the test is important to uncover potential problems sooner.

To make an appointment with Dr. Walsh, talk to your obstetrician or your child’s pediatrician. You may also call 336-713-4500.

*Sponsored by Brenner Children’s Hospital