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Each year, more than 35,000 babies in the U.S. are born with congenital heart conditions, the most common type of birth defect. While some congenital heart defects need minimal or no treatment, others require specialized medical care immediately after birth.
"Most major forms of congenital heart disease can be detected as early as 12 weeks into the pregnancy," says pediatric cardiologist Mark Sklansky, M.D. "We have been able dramatically to improve the prognosis for these patients because of our ability to detect problems early and then develop an optimal delivery plan of care."
UCLA offers a full-service fetal-cardiology program that interfaces with multiple disciplines - including maternal fetal medicine, pediatric and adult cardiology, pediatric cardiothoracic surgery, neonatology and nursing. Soon after a heart defect is diagnosed, parents begin meeting with the specialists who will be involved with treatment, and tour the neonatal and cardiothoracic intensive care units where their child will receive continual monitoring and nursing care.
Among the technologies used to provide comprehensive evaluation and monitoring of the unborn child with congenital heart disease are first-, second- and third- trimester transvaginal/transabdominal echocardiography, which utilize state-of-the art 2D, 3D, and 4D technology to evaluate the fetal heart. Additionally, fetal-heart monitoring may be conducted during the third trimester to check for fetal distress and intervene when necessary. For infants anticipated to require invasive cardiac catheterization or surgery soon after delivery, arrangements can be made for the mother to deliver in the same facility (Ronald Reagan UCLA Medical Center) where the surgery will occur. This capability eliminates the need for transport and delays in management, and prevents mother and child from being separated.
"A major benefit of a program like UCLA's is that our team includes all the necessary subspecialists for treating both mother and child, and all under the same roof," says Dr. Sklansky. "In a high-risk pregnancy that requires hospitalization for treatment of a fetal condition, such as a fetal arrhythmia, there are really two patients. At UCLA, we have both adult and pediatric cardiologists, working collaboratively with obstetricians and maternal-fetal medicine subspecialists, to provide both the mother and fetus with state-of-the-art, comprehensive care." An increasing percentage of children with even complex heart defects are surviving into adulthood and leading active, productive lives.