hole in my unborn baby's heart

I had blood work done around 16 weeks and it came back abnormal. So I was sent to another dr for a level 2 ultra sound bc my baby coul dhave trisomy18. this ultra spund showed 2 holes in the babys heart. one the dr said was 3-4 times larger than normal. So i had an amnio done that day. From the amnio test showed no trisomy18. I was so happy to hear this, but the hole in my babys heart is scaring me bc the dr said it was 3-4 times larger. I went back for another ultra sound at 29 weeks. Th hole measured the same was not smaller or bigger. So they want me to come back at 34 weeks to have another ultra sound to check the babys heart. What does this mean by it being 3-4 times bigger than normal. What problems could this cause for my baby. And they talked about surgery sfter she is born. How long will she have to stay in the hospital. What surgerys will they do. Also they said the hole in the heart could restrict blood flow. What risks does my baby have when she is born. I just want to know as much as I can so I can better take care of her.

[Elaine Brown, MD]

Hi!
I'm so happy that your amnio turned out OK.  It sounds like your baby may have an ASD and a VSD.  I am just guessing.  Normally the upper 2 and the lower 2 chambers of the heart are not connected to each other.  It is pretty common for an ultrasound to pick up an opening in a developing baby.  Depending on the size, many of these holes will close on their own as the baby grows.  If they don't sometimes it is necessary to patch them--for that a pediatric cardiac surgeon is usually consulted.  Sometimes the procedure is very simple. and other times more complex and can require more than one surgery.  Also, often, the doctors like to delay the surgery as long as possible, because a bigger heart is easier to operate on.

My guess is that your baby will need a heart ultrasound ( Echocardiogram) after birth.
She may need care in the NICU, and may need surgery right away, OR could go home with you depending upon what exactly is wrong and when/if it needs to be repaired.

Sorry I can't be more definitive, but I don't know her diagnosis--only a guess.

Good luck and congratulations in advance!
Dr B

[mamiJ]

Hi athrasher.

My daughter had one big hole in the middle of her heart when I was pregnant with her. They told me all of the same things they told you about Down's etc...

The bottom hole (VSD) closed on its own, but the top hole (ASD) was surgically repaired when she was six months old.

PLEASE....do NOT wait until your baby is born to see a cardiologist. There are fetal programs in most major Children's hospitals that start doing echocardiograms while you are pregnant. This will allow them to closely monitor the rest of the baby's development and to better prepare for how to care for baby.

Also, the answer that the doctors wait until the baby is older because a bigger heart is easier to operate on is not true anymore....it was 10 or 20 years ago. Technology is better and so are the surgeons.

My daughter was originally slated to have her surgery at 1 year, but they moved it up to 6 months because the surgeon wanted to get it fixed to avoid any complications that could arise from waiting.

I am fortunate enough to live near (IMO) the BEST cardiac pediatric surgeon. But, like I said most major children's hospitals have great programs, but I would not have it done anywhere else.

My daugther is 4 years old now. She has some minor health issues, but she is a normal, happy, active and very intelligent little girl.

I wish you the best and please feel free to let me know if you have any questions.

Take care