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Perinatal Cardiology and Fetal Echocardiography Mary T. Donofrio MD Director of Perinatal Cardiology and the Non-invasive Imaging Laboratory The Medical College of Virginia |
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The perinatal cardiologist is a pediatric cardiologist who has special training in the fetal cardiovascular system. Together, the obstetrician, perinatologist, geneticist and perinatal cardiologist form the perinatal cardiology team who's job is to care for the fetus with congenital heart disease, fetal arrhythmias, and intrauterine heart failure.  With advanced technology it is now possible to image the fetal heart and the arterial and venous connections with excellent resolution. The accurate prenatal diagnosis of congenital heart defects allows for preplanning and organization of subspecialists at the time of the delivery. This will assure appropriate early care of the infant, and may improve the outcome following intervention. Lifesaving treatment of cardiac dysfunction or fetal arrhythmias can be accomplished by delivering medicine to the mother. Occasionaly, termination of the pregnancy may be the most appropriate option for a family, and the presence of a dedicated perinatal team can give information to aid in the decision making process. | |
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High risk patients in which a comprehensive fetal echocardiogram may be indicated include the following: 1) abnormal obstetrical ultrasound suggesting a fetal heart malformation, multiple congenital anomalies, or hydrops; 2) abnormal fetal chromosomes or ultrasound findings suggesting aneuploidy; 3) family history in first degree relatives of congenital heart disease or a genetic syndrome associated with congenital heart disease; 4) maternal diabetes, collagen vascular disease, or other metabolic diseases such as phenylketonuria, pheochromocytoma, or hyperthyroidism; 5) maternal exposure to drugs such as lithium, anticonvulsants, retinoic acid, vitamin A, or alcohol; 6) prolonged use of indomethacin for tocolysis; 7) maternal viral infection (especially rubella, syphilis, CMV, or enterovirus); 8) presence of an arrhythmia by ultrasound or biophysical profile; 9) discordant twin syndrome.
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click image to download movie of echo in mpg format |
| Labeling Definitions: LV = Left Ventricle RV = Right Ventricle LA = Left Atrium RA = Right Atrium AoV = Aortic Valve |
click image to download movie of echo in mpg format |
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For more information or to schedule patients for a visit at the Perinatal Cardiology Center
call 804-828-9611, or contact Dr. Donofrio at mdonofrio@hsc.vcu.edu.
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Contact
Richard P. Embrey,
M.D. for questions |
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