Fetal Cardiac Dysfunction—Child

Definition

Fetal cardiac dysfunction refers to a number of heart problems in a growing fetus. For example, the heart can be:

• Pumping weakly
• Pumping irregularly

The heart is not adequately able to move blood through the fetus’s body. This can cause distress in the fetus. The condition can range from mild to severe.

Blood Flow Through the Heart

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Causes

Cardiac dysfunction may be due to:

• Genetic diseases that affect the heart
• Problems with structures of the heart
• Infections
• Exposure to certain substances (eg, drugs, alcohol, nicotine, some medicines)

Risk Factors

General risk factors for heart problems include:

• Family history of congenital heart defect
• Certain chromosomal disorders in the child
• Previous pregnancy with fetal heart abnormalities or miscarriage
• Conditions during pregnancy, such as:
  • Being infected with a virus (eg, rubella)
  • Having poorly controlled diabetes
  • Drinking alcohol
  • Taking certain medicines (eg, isotretinoin for acne)
  • Inadequate blood supply to the fetus

Symptoms

The symptoms depend on the type of defect. The doctor will monitor your baby’s growth and heart rate during the pregnancy. During fetal monitoring, the doctor may detect an abnormal heartbeat, such as:

• Irregular—extra or missed beats
• Tachycardia —heart beats too fast
• Bradycardia —heart beats too slowly

During imaging tests, the doctor may also detect:

• Abnormal heart structure
• Blood flow problems

Diagnosis

Fetal cardiac dysfunction can be detected using special tests during pregnancy, such as:

• Fetal ultrasound—a test that uses sound waves to get pictures and data on the baby’s growth and organs
• Fetal echocardiogram —a specialized cardiac ultrasound that uses sound waves to look at the size, shape, and motion of the heart
• Fetal MRI scan —a test that uses magnetic waves to make pictures of the baby’s chest, abdomen, and brain
• Amniocentesis —the removal of a small amount of fluid from the uterus (womb) to test for genetic abnormalities and to check the baby’s development

Treatment

Talk with the doctor about the best treatment plan for your baby. During your pregnancy, you will need to be examined by specialists, such as:

• Perinatologist or maternal-fetal medicine specialist—a doctor who specializes in the treatment of high-risk pregnancies
• Pediatric cardiologist—a doctor who specializes in heart conditions in children

There are many categories of this condition. Treatment depends on the type of defect. In certain cases, the problem can resolve on its own.

In other cases, the condition may be treated during the pregnancy. For example, surgery may be done to repair abnormal structures while the baby is in the uterus.

After your baby is born, he may need medicine or surgery. Examples of surgeries that may be done include:

• Catheterization —a catheter (tube) is inserted through the veins and into the heart for testing or a procedure
• Pacemaker insertion —a small, battery-operated device is inserted into the heart to maintain a normal heartbeat

Prevention

Make sure you receive good prenatal care:

• Visit your doctor regularly. Your doctor will monitor your health and the health of your baby. Certain tests may be able to detect a heart defect in a growing fetus.
• Have a healthy lifestyle. Eat healthy food and take prenatal vitamins.
• Do not drink alcohol, smoke, or use drugs. This is especially important if you are pregnant.