Congenital heart disease (CHD) impacts six to eight in every 1000 children born in India. According to statistics, approximately 1.5 to 1.8 lakh babies are born with CHD. Dr Sanjay Wazir, consulting neonatologist, Cloudnine Group of Hospitals, Gurgaon says, “Although most newborns with critical CHD exhibit the symptoms and are identified soon after birth, some are not diagnosed until after they are discharged from the hospital. This makes screening for CHD immediately after birth very important. CHD can be detected through clinical examination and by performing the pulse oximetry test which measures the baby’s pulse and oxygen levels in the blood. A low oxygen level is an indicator of CHD.”
Congenital heart disease occurs due to a defect in the formation of the heart, so avoiding agents that are likely to interfere with organ formation in the foetus should be avoided to lower the risk of CHD. “Taking medications such as retinoic acid for acne, alcohol or drug abuse during pregnancy, and poorly controlled blood sugar in women who have diabetes during pregnancy have been shown to increase the likelihood of congenital heart disease in the baby. It is not always possible to determine the cause of congenital heart diseases, but most tend to be genetic and get passed down through families. CHD is also not entirely preventable as most cases happen in mothers with no risk factors. But as mentioned earlier, with timely diagnosis and the right treatment, children with congenital heart defects are able to lead active, productive lives,” explains Dr Wazir.
What makes early diagnosis extremely important is the fact that children with high-risk CHD can die if they are not diagnosed early enough and given the right interventions, or even if they survive, chances are they will have uncorrected heart defects in adulthood which will require medical attention later. “It is imperative that babies with congenital heart disease are either identified in-utero or immediately after birth for better outcomes and a healthier life,” adds Dr Wazir.Talking about the efficacy of the diagnosis and treatment, Dr Wazir says, “Globally as well as in India, treatment for most cases of CHD consists of either surgery or catheter procedures or a combination of the two depending on the type and severity of the heart defect. These treatments have a good success rate provided babies with CHD are diagnosed early enough and reach the hospital on time. Unfortunately, for several reasons, most babies are diagnosed late and reach the hospital in a critical stage which reduces the efficacy of these treatments.”
A good level II ultrasound in the second trimester, which is a special type of scan to examine the foetus for abnormalities, can provide a relatively fair assessment of any abnormalities in the heart. However, in high-risk pregnancies where the mother has a condition like uncontrolled early diabetes, a foetal echocardiography should be performed by a pediatric cardiologist.
After birth, a very simple technique of checking the oxygen levels in the baby by applying a small probe of a pulse oximeter on the hand and the foot can detect critical CHD. A pulse oximeter is a cheap device and one does not require a high level of clinical expertise to be able to perform this test. In fact, hospitals across the country should make it a standard practice to perform this test on every baby who is born before he/she is discharged from the hospital because this simple and cost-effective step can save many precious lives each year.
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