Pediatric Heart Expert Forum
multiple VSDs ,ASD and PDA
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Questions in this forum are answered by pediatric cardiologists, cardiothoracic surgeons and anesthesiologists from The Children's Hospital of Philadelphia. This forum is for questions and support about pediatric heart problems, symptoms and topics such as heart murmurs, palpitations, fainting, chest pain, congenital heart defects (including management and intervention), fetal cardiology, adult congenital cardiology, arrhythmias and pre-participation athletic screening.

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multiple VSDs ,ASD and PDA

Dear Dr. Jeffrey,
When i first got pregnant i had a misscarriage at 12 weeks of pregnancy.In my 2nd pregnancy my daughter was born with multiple VSDs on the septum wall as well as on muscular side, 2 ASDs and a PDA.All these got repaired through surgery except 2 tiny muscular VSDs(dr. said that it was hard to reach to them and they will not be a problem in future). I want to ask that what are the chances of getting CHD in my 3rd child if i had a misscarriage and a child born already with CHD?
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Dear Jia,

The incidence of congenital heart defects is approximately 1%, or 1 in 100 babies born.  Once you’ve had a child with a congenital heart defect, assuming that:   you have had no other children with congenital heart defects , that there are no genetic syndromes in your family, and that you do not have advanced maternal age (>35 years old), that risk goes up to only 2-5%.  This means a 95%, or better, chance that your next baby will be fine.  Factoring in the miscarriage is probably not a problem, as OB/GYN doctors typically do not get concerned about miscarriages until you have had at least 3 of them.

Since you have had a child with congenital heart disease, I would recommend that you undergo fetal echocardiography during the second trimester to evaluate for evidence of structural defects.  Fetal echo does not catch all defects, and certainly can’t see the tiny ones, but can find the large majority of them, and certainly the major ones that might require preparation when your baby is born.
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Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
Philadelphia, PA
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Marie M Gleason, M.D.Blank
The Children’s Hospital of Philadelphia
Philadelphia, PA
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