Stories about: ultrasound

Why it’s important to ask about your baby’s heart during an ultrasound


Did you know that at least half of all babies born with a heart condition are not diagnosed during pregnancy? Heart defects can seriously impact a child’s health, but knowing ahead of time will allow you to find the right people who can help. In some cases, prenatal detection can lead to earlier treatment for the baby.

Watch this short video to learn what to ask at your 18- to 22-week screening ultrasound to make sure your baby’s heart is healthy. If you don’t feel comfortable asking the questions yourself, download the questions and share them with the person performing your ultrasound.

Taking a few extra moments at your ultrasound is an important first step to managing your child’s health. Your baby might not be born yet, but they’re already counting on you.

Explore bostonchildrens.org/fetalheart for more information and resources.

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Francesca’s story: Beating a heart tumor

Francesca, who was diagnosed with a cardiac tumor before she was born, with her Although her parents were warned she might not breathe when she was born, the moment Francesca Durkos came into this world, she let out a gutsy cry.

“It was music to our ears,” says her mom.

Michelle Carino Durkos was 40 weeks pregnant when she learned there was a tumor attached to her unborn daughter’s heart — a tumor so large that doctors near her home in Pensacola, Florida, were unsure if the baby would live.

“It was a shock, because at 20 weeks everything was normal,” says Michelle. “We had a wonderful ultrasound; we saw all four chambers.”

Yet, call it a mother’s intuition, Michelle knew something was wrong.

“The whole pregnancy I had this strange feeling. I didn’t want to upset her, so I’d sleep sitting up, as if she was fragile — as if she was in distress.”

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Video: Caring for kids with congenital heart disease

As Director of Ultrasound Imaging Research at the Heart Center, Dr. Gerald Marx is passionate about advancing non-invasive imaging and its role in diagnosing congenital heart disease.

Many of his patients who were first diagnosed in utero are now going off to college.

“This has become an extraordinarily technological field that we are in,” he says. “But within all that technology has to be the human interaction, the human feeling that the medical system cares about their son or daughter as a person and as a patient.”

Learn more about the Division of Non-Invasive Cardiac Imaging.

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How fetal testing can change the outcome for kids with heart defects

Lindsay had open-heart surgery at Children's a week after birth

Yesterday we shared a patient story, written by a mother whose baby was born with a congenital heart defect (CHD) that wasn’t recognized until hours after birth. Thankfully, once her condition was discovered, baby Lindsay was rushed to Children’s Hospital Boston in time for open-heart surgery. It’s a story with a happy ending, but Lindsay’s first week of life was very touch and go, which caused her parents almost unbearable amounts of stress and worry.

But had Lindsay’s heart defect been recognized prior to birth, much of that anxiety might have been avoided. When a heart condition is diagnosed prenatally, caregivers can proactively provide additional testing, delivery planning and counseling that benefits the baby’s health and parents’ piece of mind.

In some cases, it’s even possible to perform fetal therapy on the child before he or she is even born. Children’s Fetal Cardiology Program can try to repair heart valves the size of a pen point in a fetal heart no bigger than a grape; all while the child is still in the mother’s womb.

Wayne Tworetzky, MD

Fetal or in-utero therapy is a very complex process that brings together cardiologists, obstetricians, anesthesiologists and nurses in a team effort to perform these procedures. In the following video, Wayne Tworetzky, MD, director of Children Fetal Cardiovascular Program discusses how difficult these procedures can be, not just because of the small size of fetal hearts, but also because of complications that can arise from performing invasive surgery on a fetus when the mother carrying the baby is perfectly healthy.

In-utero heart surgery is an amazing feat of modern medicine, but before doctors ever get to that point a problem needs to be recognized. Ultrasounds are essential in monitoring fetus development in the womb, but they’re not perfect.

“Virtually all pregnant women who receive pre-natal care will have a fetal ultrasound during the course of their pregnancy, but that doesn’t mean the ultrasound catches everything,” says Tworetzky. “Congenital heart defects such as hypoplastic left heart syndrome or transposition of the great arteries, and others, can be detected by ultrasound, but research shows that about half the time, they’re overlooked.”

Fetal ultrasounds don't always catch potential heart defects

When heart defects go undetected it can produce a host of health problems when the child is born, many of which can have long-lasting effects. But when heart conditions are caught early, caregivers can provide parents with counseling on treatment options and a planned delivery with appropriate pediatric and obstetric staff present.

“With planned and specially managed care before and after delivery of a child with a CHD, caregivers can treat the infant’s heart right from the start,” Tworetzky says. “They can also minimize the risks for future problems.

Download these tips in PDF format for you to print and bring to your ultrasound

During a fetal ultrasound, Tworetzky suggests parents ask the technician and the doctor the following questions concerning the fetal heart:

  • Do you see four chambers in the baby’s heart? (Desired answer is yes)
  • Are there two upper chambers (left and right atria) with valves controlling blood flow into the heart? (Desired answer is yes)
  • Are there two lower chambers (left and right ventricles) with valves controlling blood flow out to the body (aortic) and lungs (pulmonary)? (Desired answer is yes)
  • Do the two valves and vessels (aorta and pulmonary arteries) exit the heart in a crossing fashion? (Desired answer is yes)
  • Are there any large holes between the lower chambers of the heart? (Desired answer is no)
  • Is the baby’s heart normal? (Desired answer is yes)

If the answers to the above are as desired, then almost all serious heart defects, and  > 90% of all heart defects, can be ruled out.

If the ultrasound shows the possibility of a heart defect, parents should immediately make an appointment with a pediatric cardiologist, who will have access to the most advanced and accurate diagnostic tests. “If further testing show signs of a heart defect your caregivers will help you plan appropriately for your baby’s birth,” Tworetzky says. “This way you’ve given clinicians as much time as possible to make the birth, and early treatment, as smooth as possible.”

One treatment option—and it sounds like something out of science fiction—is repairing CHDs on hearts no bigger than a grape while the baby is still in the mother’s womb.

As you might imagine, it’s an incredibly complex and delicate procedure that brings together doctors, surgeons and nurses. In the video below, Tworetzky discusses how difficult these procedures can be, not just because of the small size of fetal hearts, but also because of complications that can arise from performing invasive surgery on a fetus when the mother carrying the baby is perfectly healthy.

And in this recent interview with NPR, Tworetzky talks about fetal cardiology and we hear from the parents of a Children’s patient who had surgery while she was still in her mother’s womb.

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