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Doctors and nurses talk about the Fetal Heart Program at The Children's Hospital of Philadelphia. From referral and diagnosis, planning and delivery to treatment and the future, doctors and nurses are making great strides in the diagnosis and treatment of congenital heart defects. Use the links below to navigate through the series.
Denise D. Donaghue, RN: The whole point of the this program was to make this easily accessible -- to make the resources at The Cardiac Center easily accessible to families and patients and to referring physicians.
Peter J. Gruber, MD: Most of the kids that come through an outside physician's office do not have these complex diseases so they really provide the first line in one of the most difficult things and that is to identify these kids to begin with and get them into the program.
Denise D. Donaghue, RN: Most of our families are coming from their high-risk obstetricians or even being referred from pediatric cardiologists, locally or across the country.
Unknown Speaker 1: When patients are referred here for an evaluation prenatally, they under go a fairly intensive, usually, one-day evaluation.
Unknown Speaker 2: Typically that's done through a level II type ultrasound, an obstetrical ultrasound, where the fetus is scanned from top to bottom looking at other organ systems besides just the heart itself.
Unknown Speaker 3: That's to make sure that there are aren't other abnormalities that coexist with a primary cardiac abnormality.
Jack Rychik, MD: In many, many cases congenital heart disease is isolated. It occurs on its own. But often times it can occur within a context of some other type of problem. There are a number of chromosomal anomalies that can be associated with different forms of congenital heart disease. Common things being Trisomy 21, or down syndrome. There can be other forms of Trisomy diseases, which unfortunately have a much poorer outcome.
Micahel W. Bebbington, MD: They may or may not then also have a fetal MRI added to the evaluation and then they have the extensive fetal echocardiography.
Unknown Speaker 3: The key to the fetal program is imaging -- to be able to do ultrasounds and make the diagnosis of congenital heart defects very early in fetal life.
Jack Rychik, MD: We now have technologies that can allow us to look at the fetus as early as 10 to 12 weeks gestation.
Denise D. Donaghue, RN: We actually have two dedicated fetal sonographers that this is all they're doing.
Zhiyun Tian, MD: We are very confident when we do the scan. So it makes the patient also feel more comfortable.
Peggy McCann, RDCS: My job is to really get a full understanding or as best of an understanding as we can have for how these babies are going to behave after they're born.
Jack Rychik, MD: To analyze the structure of the heart, both from an anatomical and a structural standpoint and a functional standpoint begin to look at blood flow patterns.
Peggy McCann, RDCS: It's incredible the things that we can see today. We can see almost everything. By the end of the pregnancy, we can really get a good understanding with what the baby's physiology is going to be.
Zhiyun Tian, MD: Every baby looks like a real baby to me because I can see baby's movement. I can see baby's hands. And I can see baby's, you know, heart and entire circulation.
Denise D. Donaghue, RN: If we didn't have the diagnostic images to track and trend, there's a lot that we would not be able to help anticipate with and for families.
Andrea Thrush, parent: It's hard to hear it, but it's -- was for us easier to accept and understand.
Kim Persick, parent: Because then you can prepare yourself for when the baby's born and what needs to be done.
Jack Rychik, MD: I'm very pleased to be able to give you some good news today.
Unknown Speaker 4: After they have their first scanning, they sit down with one of the physicians and the nurse coordinator. And they're told in extensive detail what the diagnosis is.
Anthony Ramsay, parent: They explained what, you know, could happen. You know, how the heart - -the makeup of the heart was a little bit different than other babies. Just to talk about -- like, the way the blood flow is going to happen -- talk about the different stages of the operation.
Jack Rychik, MD: Having this information up front, knowing about the spectrum of these anomalies up front, can certainly help families, in terms of decision-making, and can also be helpful, in terms of preparation and knowledge, about what needs to be done when these babies are born.
Andrea Thrush, parent: Our outcomes are much better, we feel, because we knew and had time to plan and understand the concept of everything.
Contact the Fetal Heart Program for more information