Thursday, February 17, 2011

CHD Detection

When it comes down to it, Congenital Heart Defect detection begins at the prenatal ultrasound. It's true, some babies, whose special hearts are not screened prenatally can come into this world with hospital staff that are unaware and unprepared to provide immediate and specialized treatment.

Other times, babies are born - seemingly healthy - brought home; and hours or days or weeks later, sometimes without any clues or indications, like sweet little Cora's tragic story, turn into emergency situations or even death.

Diagnostics. Awareness. Advocacy.

These three things can save a baby's life.

I was so thrilled to read an article about a local (Winnipeg) sonographer who IS making a difference in the diagnostic aspect of CHD's. Read it if you have a minute. This is someone who has gone beyond the call, to ensure CHD's are detected.
Click here to read the CBC story on Karen Letourneau.

As a pregnant mom-to-be, it's also up to you to be sure your baby is being screened for any heart problems. I know we have to trust our health care professionals, I certainly do. I can't be an expert in every field, and I trust those who are. However, to be aware gives you the power to ask the right questions, to open dialogue with your health professional.

I came across an article, in which Dr. Nina Gotteiner, a pediatric cardiologist at Chicago Children's Memorial Hospital gives a list of 5 proactive questions that every expecting parent should ask regarding their 20 week ultrasound:

1. Do you see 4 chambers?
2 Do you look at the arteries of outflow tracks as part of your scan? *Note: Extremely important to focus on artery views. CHD is often missed if only a standard 'chamber view' is performed.
3. Are the heart and stomach in correct positions?
4. Is the heart rate normal? Is the heart rate too slow (less than 100 beats per minute), too fast (over 200 beats per minute), or irregular? *Note: A normal heart rate range is 120-180 beats per minute.
5. Is the heart function normal? Does the muscle work normally? Is everything hooked-up correctly?

Knowledge is power. Just by asking the right questions and being an advocate for your baby's health is a step towards greater awareness. You can read the whole article here.

Pulse Oximetry. This is another big one. This is a very simple, totally painless, non invasive diagnostic tool, that should be used after baby is born and before you go home. This is that little sensor, either put over a toe or a finger with that little red light that detects oxygen saturation. A low oxygen sat may indicate the presence of a heart defect.

And Nate's story?

Well, it's not the first thing to come out when someone asks about Nate. In fact, I haven't told too many people. And there are a couple of reasons. But here's a quick glimpse into our diagnostic story.

I went in for my routine ultrasound. This was my second pregnancy, so I kind of knew what to expect with the ultrasound appointment. And it was going routinely for the first while; scan around my belly, hold for the measurements, click for the image being saved. This went on for a while. Then the 'clicking' stopped. The ultrasound tech was no longer taking measurements or saving images. She was doing a lot of looking. From all different angles. This was taking a long time, and in my mind I was already thinking worst case scenario. Something was wrong. After a very long time, she honestly told me she was having trouble seeing some areas, and was just going to get the radiologist to come in and take a look as well.
The radiologist came in, and together they did some more looking. I kept hearing them talk about the right side and the left side, but I didn't have a reference to what they were talking about. Finally, at the end, he said they were just trying to get a good look at the heart, but with a pat on my leg, he assured me everything looked good.

I applaud my ultrasound tech. She knew something was up, there was something different, and she did the right thing, calling in the radiologist. If I could talk to her now, I would tell her she was on to something!! She was right, that things were not as they should be. It would be great to go back to those ultrasound images and turn it into a learning opportunity. Chances are she had never seen this CHD before, and like you already know it's a complex one!

And I thank God. I am so thankful that Nate's heart did not need any immediate intervention at birth. It scares me to think about what could have happened had things been any different. But God was in control of this situation. He knew Nate would be okay at birth and gave us the most incredible gift that day....our sweet little Nate!

1 comment:

Donald Lepp said...

One other interesting mention that you are fortunate that Nate did not need intervention immediately after birth...and that is very fortunate. We know a couple of families who did require intervention immediately after birth. Because of early detection they were sent to Toronto or Edmonton before their babies were born. In one case, transplant was the only option. Their son was listed for transplant several weeks before being born. All possible through early detection.