The most common birth problem among newborn babies

Dr Naomi Gachara

Congenital Heart Defect (CHD) are the most common birth defects among newborn babies. The heart begins to grow at conception and is completely formed eight weeks into pregnancy. Congenital heart defects arise during this period.

The vast majority of causes remain unknown, but risk factors include mothers with metabolic diseases such as diabetes mellitus (especially if the condition is not well managed) and maternal exposure to infections and drugs for example, those that control epilepsy. Also, pregnant mothers who have had CHD and those who drink alcohol and smoke expose the foetus to the danger of this disease.

Two per cent

When a previous child has CHD, the risk of another one developing the same problem in a subsequent pregnancy increases by about two per cent. The risk is also increased if the father has, or had the defect.

Congenital heart diseases range from simple to complex lesions (tissue damage). The symptoms depend on the severity of the lesion. Several heart diseases generally become evident during the first few months after birth while others are detected right after delivery. The minor problems are discovered during routine medical check-up.

Signs of CHD include fatigue which may be manifested with poor and interrupted breastfeeding, shortness of breath, excessive sweating, puffiness, bluish tint of the skin, lips and finger nails (which worsens when the baby is crying), poor weight gain and delayed milestones. This problem does not usually occur with chest pain, or other hurting symptoms.

Spontaneously

A child suspected to have a CHD should be referred to a paediatric cardiologist who will perform tests to confirm the diagnosis. Treatment of congenital heart diseases varies with each individual. Some cases like the small holes that close spontaneously do not require any intervention. Others will initially need medical management in form of anti-failure drugs and later the definitive cure which is either surgical or interventional cardiology.

The surgical treatment involves either open, or closed heart surgery. Interventional cardiology is performed by cardiologist to close some specific cardiac lesion with devices, or to balloon stenosed (narrowed) valves.

To prevent CHD mothers are advised to avoid toxic substances such as alcohol and drugs during pregnancy. These damage the developing heart of a foetus. Good prenatal care is paramount for a mother who may have been detected to have a foetus with CHD. Children with CHD need only occasional check-ups with a cardiologist as they grow up. Those who have complex heart defects need long-term special care.

—The writer is a Paediatric Cardiologist at Aga Khan University Hospital