General

20-minute review of problems in the womb

20-minute review of problems in the womb

In order to understand the problems in the womb, Ek Fetal Echocardiography ses uses sound waves and the mother and the baby do not suffer or suffer. With this ultrasound, the baby's heart is examined. The examination takes about 20 minutes if the baby's position is reversed and does not interfere with imaging. Situations such as the position of the baby in the mother's abdomen and the mother being fat can sometimes cause the examination to take longer. Sometimes it is not possible to examine the baby's heart on the same day, so the next day the mother is called again. Mothers should not be concerned about the length of the examination. Even in a normal baby, the procedure may take longer due to its position.

Acıbadem Bakırköy Hospital Pediatric Cardiology Department Responsible Dr. Ayse Sarioglu, this review was carried out from the 16th week of pregnancy, he says. In the earlier period, transvaginal examination is performed through the vagina. The internal structure of the heart, the heart chambers, the heart valves, the vessels coming out of the heart are examined, the heart functions and blood flows in the heart and vessels are examined. Although fetal echocardiography can be performed in every period of pregnancy, it is preferred between 16-20-22 weeks. If there is a serious heart anomaly, it is sometimes necessary to terminate the pregnancy. Although it is associated with chromosomal anomalies, it may come to an end.

Fetal echocardiography is not performed on all mothers. Obstetricians who have been trained in this field, ie perinatalogs, request this examination if necessary. Perinatologists examine the baby's organs as well as the heart. If they think of any abnormality or if the baby is at risk for congenital heart disease, they send it to pediatric cardiologists for detailed examination and planning the necessary treatment. Fetal echocardiography should also be performed by experienced pediatric cardiologists with special training.

In what situations is fetal echocardiography needed?

- If heart abnormalities are detected
- If there are abnormalities in other organs of the baby
- Chromosome anomaly
- If the mother has diabetes, goiter or chronic disease and is on medication
- If there is congenital heart disease in one of the close relatives of the mother, father, one of the brothers, aunt-aunt, uncle and their children
- In case of su hidrops te in the baby, water accumulates in the abdomen.
- If the water in which the baby is swimming is too much or too little
- If the mother has had an infection, has received radiation, has taken medication
- If there is a problem with the baby's heart beat, that is, if there is a rhythm disorder
- In case of repeated in vitro fertilization, fetal echocardiography should be performed in case of in vitro fertilization, twin or multiple pregnancy.

However, more than one discipline must work together to carry out all these investigations. Referring to the importance of Turkey in the increasing number of perinatology expert Prof. Dr. Ayşe Sarıoğlu, ası Increasing this number will increase the rate of diagnosis of congenital diseases in the womb. That is why it is very important to work in teams. Our team includes gynecology, cardiac surgery, pediatric cardiology, anesthesiology, radiology, neonatal intensive care specialist and perinatology specialist. We share all the information and offer treatment to our patients with common decisions. ”

What is the treatment?
If you have a rhythm disorder:
There may be rhythm disturbances in the womb. The palpitations are examined when there are decelerations. It is impossible for the mother to feel the rhythm disturbances in her baby's heart. Rhythm disorders are not always very bad, there are also benign rhythm disorders, some of which may disappear after childbirth, some continue after childbirth. It may also be the ones that cause heart failure in the mother's abdomen. In this case, the mother is given medication or medication is given by giving the baby cord.

Cap tightness:
Although the treatments are not routinely applied, they become widespread. The valve stenosis can be opened with a balloon.

Postnatal treatments:
Some heart problems require intervention as soon as they are born. If the heart problem is known before birth, it is already decided where and when to give birth and what kind of intervention is required. Birth cardiac surgery is performed in the pediatric heart center where the newborn specialist and pediatric cardiologist is present, and the necessary interventions are performed without any delay by medical, surgical or catheter method, and the chances of the baby's health are significantly increased.
Watch out after the baby is born!

After the babies are born, some symptoms need to be observed and monitored. The circulation in the womb is different. The upper chambers of the heart have a hole, some vascular openings. Even if there are serious heart problems, this feature of the circulation makes it possible to arrive without any problems until delivery. After the first breathing after birth, the hole between these vascular openings and the upper chambers of the heart closes, lung pressure decreases, blood starts to go to the lungs. In other words, normal heart and lung circulation starts and problems arise with this circulation.

The sound of murmur should be examined:

The most common finding in the period after birth is the sounds of blowing in addition to the heart sounds that we call murmur during the examination of the heart. Murmurs are usually heard in patients with heart problems, but they can be heard without heart problems. We call them functional, innocent murmurs. A pediatric cardiologist must be able to see a baby who is heard murmurs. Not to mention innocent murmur. It cannot be distinguished without echoing.

Bruising important:

Sudden bruising may occur, and sometimes may occur slowly, this is a very important symptom. Mothers under the baby's eyes, the upper side of the lip can interpret the bruising as a disease. However, the bruises on the nail bottoms and lips in the mouth are important. Bruising may also occur around the mouth, although this does not mean heart disease, mothers may consult their pediatrician.

If she does not gain weight:

When the baby is gaining good weight, he cannot gain weight from the third-fourth week, he gets tired while sucking, and can be a symptom of heart disease if he is sucking.

Frequent breathing and moaning:

Some mothers notice that their babies breathe very quickly. Babies have a high breathing rate, but babies with heart disease breathe much faster, sometimes they can add whimpering and sometimes excessive sweating.

Ribs on the ribs:

If there are inward recessions under the ribs, this may be a sign of heart disease.

Frequent febrile illness and pneumonia:

Infants with heart disease are more susceptible to infections and pneumonia and bronchitis than other infants, and if there are recurrent pneumonia attacks, babies should be examined for heart disease.