The most common congenital anomalies in the newborn belong to
the heart. Heart anomalies are present in 5 to 8 of every 1000 newborn babies.
There are many types of congenital heart anomalies. A significant number of
these do not require any immediate treatment. For example, those that are
smaller than the openings (ventricular septal defect) in the wall between the
two ventricles are mostly closed at later times. It is not possible to detect
some anomalies (such as some of the aortic stenosis) before delivery.
There are two important factors during the evaluation of the
heart in ultrasonography during pregnancy. The second important image is to
monitor that the large vessels (aorta and pulmonary artery) coming out of the
heart are in the correct position. If these two images are normal, almost all
of the important problems in the heart can be considered to have been
eliminated, and they provide about 90% healthy information. The best time to
display four chambers in the heart and to view the exit routes is between 18-22
weeks of pregnancy.
In cases where further examination of the fetal heart is
required, fetal echocardiography is used.
Fetal echocardiography is required in risky situations such
as the presence of a congenital heart disease in the mother, a diabetic mother,
a history of giving birth with a congenital heart anomaly, and arrhythmias in
the baby heartbeat.
Increased monitoring of neck thickness measurement (NT)
between 11-14 weeks of pregnancy also creates suspicion about congenital heart
diseases. It has been reported that NT measurement increases in at least 25% of
fetuses with congenital heart disease. Therefore, fetal echocardiography is
recommended for fetuses with increased NT.
Risk
factors for congenital heart anomaly:
- Risk of congenital
heart anomalies in the fetus increases in pregnancies with the following risk
factors.
- Congenital heart anomaly in the mother or father
- Having had a child with a heart abnormality before
- Exposure to drugs or substances that are cardiac
teratogenic (lithium, folate antagonists, organic solvents, thalidomide,
isotretinoin, anticonvulsants ..)
- Diabetes in the mother (risk does not increase in
gestational diabetes)
- Having phenylketonuria in the mother
- The use of prostaglandin synthetase inhibitor drugs of the
mother during pregnancy (causes early closure of the ductus arteriosus)
- Having had rubella during pregnancy
- Detection of anomaly in an organ other than the heart in
the fetus with ultrasound
- Fetus with chromosomal anomaly
- Non-immune hydrops
- Fetal arrhythmia (rhythm disturbance in the fetus heart)
- Abnormal fetal situs
- NT (fetal nuchal thickness) is excessive
- Twin to twin transfusion syndrome (TTTS)
- Single umbilical artery
- Polyhydramnios
- SLE
Common
heart anomalies:
Fallot
Tetrology: It is the situation where 4 different anomalies coexist.
Medication or surgical treatment can be applied after birth depending on the
severity of the findings. It is not the reason for termination of pregnancy.
Large
Vessel Transposition: It is a severe anomaly. There are two types. In its
full form, the main artery (aorta) exits from the right ventricle and the main
vein leading to the lungs exits from the left ventricle. In the second form,
atria and ventricles are also involved in transposition. Although surgical
correction is a high-risk operation, there is a chance of life.
Hypoplastic
Left Heart Syndrome: It is a condition where the left ventricle is too
small and the two ventricles belonging to this ventricle are narrow or not
developing at all. It is generally associated with heart failure in the womb.
It is a very severe and poor prognosis. Termination of pregnancy may be
recommended.
The vast majority of small VSDs will spontaneously close over
time. Or a completely normal life is possible with surgical treatment to be
applied in the future.
Marfan syndrome, aortic stenosis, and VSD are the heart
abnormalities that can be passed from mother and father to the baby, that is,
the highest probability of recurrence in the family.
The most common congenital heart anomaly is the bicuspid
aorta. The most common rheumatic heart anomaly is mitral stenosis.
-CHOROID PLEXUS CYST
-CORPUS CALLOSUM AGENESIS (CCA)
-MEGA SISTERNA MAGNA
-MEGALENCEPHALY
-MICROCEPHALY
