Q: I’m pregnant and congenital heart disease runs in my family. What is my risk of having a baby with a heart defect?

Ask Our Expert About Congenital Heart Defects

About Our Expert

Louis W. Hansrote, M.D. is a pediatric cardiologist at Lehigh Valley Health Network.

• I’m pregnant and congenital heart disease runs in my family. What is my risk for having a baby with a heart defect?
  
• Should I ask my pediatrician to do extra testing, such as an echocardiogram, when my child is born?
  
• What are symptoms of a heart defect?
  
• If my child has a heart defect, will he be able to live a normal life?
  

Q: I’m pregnant and congenital heart disease runs in my family. What is my risk of having a baby with a heart defect?

A: Heart defects are the most common of all birth defects, affecting about 8 of 1,000 babies. Your family history of congenital (which means present at birth) heart disease raises your risk for having a baby with this condition and varies depending on how many people in your family were born with a heart defect. If this is your second pregnancy, for example, and your first child had a heart defect but neither you nor anyone else in your family had one, then your risk is 1 to 3 percent. On the other hand, if both you and a sibling were born with a heart defect, your risk rises to 40 percent.

Q: Should I ask my pediatrician to do extra testing, such as an echocardiogram, when my child is born?

A: Your baby may require testing, but an echocardiogram is not the first test I would recommend. An echocardiogram uses sound waves (ultrasound) to produce an image of the heart that shows whether the heart is beating normally and whether the valves within the heart are working properly. It requires placing sticky patches (called electrodes) on your baby. Although we use this test to diagnose defects, we generally do not use it to screen for them.

Rather than an echocardiogram, I do recommend a pulse oximetry test. It involves placing a clip on your child’s finger to measure the oxygen level in the blood. Blood oxygen levels in healthy babies are above 90 percent. If your child’s oxygen levels are lower, your child may need further testing and eventually require an echocardiogram.

Q: What are symptoms of a heart defect?

A: Many newborns with a heart defect will display noticeable symptoms, such as a bluish tint to the skin, rapid breathing, and cold sweats. In addition to those symptoms, your child may nurse slowly, consume very little breast milk or formula, or fail to gain weight.

Q: If my child has a heart defect, will he be able to live a normal life?

A: The answer to that question depends on the type of defect your child has. The most common heart defect is a small hole in the wall between the lower chambers of the heart. Many of these holes heal without treatment. Even if your child has a more serious defect that requires surgery, the outlook is much more positive than it was 20 years ago. For example, about 90 percent of babies with a missing heart ventricle—a defect that used to be fatal—will survive surgery and live a fairly normal life. Although these children may not excel at some sports, they are usually able to keep up with other children their age.

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