Reducing risks of heart defects in babies

Every mother’s dream is to carry a healthy baby to term. It is, therefore, both distressing and traumatising when one gives birth to a baby with a congenital birth defect such as a hole in the heart. Doctors, therefore, advise women in their reproductive age to work with their physicians before conceiving in order to lower risks of heart defects.
Throughout the nine months of her pregnancy, Layina Umana, 29, did not get any signs that her unborn baby had an abnormality. The scans showed everything was normal until the time of delivery. “The doctor told me when I was about to deliver that the baby’s heartbeat was too fast for me to go through a vaginal delivery. I opted for a C-section,” Umana recollects.
At only three days, baby Kalista Nakalembe got a high temperature and had breathing difficulties that saw her admitted in hospital. “A scan was ordered and the results showed that she had a hole in the heart,” Umana says.
Nakalembe was then referred to the Uganda Heart Institute for surgery to correct the defect. However, the surgery would cost Shs19m, which Umana, a housewife with no stable income, did not have. However, last year, a well-wisher offered to pay for the surgery and in March this year, Nakalembe underwent surgery and is still undergoing monitoring and review at the Uganda Heart Institute.
It is not uncommon to see adverts in local media seeking financial support to conduct operations either at the Uganda Heart Institute or abroad when specialised services are needed. The required money on average is $5,000 (about Shs18.8m) but almost doubles in India. It is upon this background that medical doctors caution mothers to prepare before getting pregnant.

Medications
Dr Peter Lwabi, a paediatric cardiologist, says although nothing much can be done to prevent heart defects, some medications such as those that treat depression, blood pressure and other seizures can be avoided because they have been found to increase the risks.

Risk factors
According to the US based Health line media, a private entity that provides health information, all pregnant women have some risks of delivering a child with a birth defect.
These range from family history of birth defects or other genetic disorders, drug use, alcohol consumption, or smoking during pregnancy. Others include maternal age of 35 years or older, inadequate prenatal care, untreated viral or bacterial infections including sexually transmitted infections and use of certain high-risk medications.
Women with pre-existing medical conditions, such as diabetes, are also at a higher risk of having a child with a birth defect, according to the website.

Prevention
Mayo Clinic, a nonprofit academic medical centre based in the US, focused on integrated clinical practice, education and research, also indicates that because the exact cause of most congenital heart defects is unknown, it may not be possible to prevent these conditions. However, there are some things they recommend that might reduce the child’s overall risk of birth defects and possibly heart defects, too.
A rubella infection during pregnancy may affect your baby’s heart development. Be sure to get vaccinated before you try to conceive. Also, if you have diabetes, keeping your blood sugar in check can reduce the risk of heart defects. If you have other chronic conditions, such as epilepsy, that require the use of medications, discuss the risks and benefits of these drugs with your doctor.

Folic acid
Daily consumption of 400 micrograms of folic acid has been shown to reduce birth defects in the brain and spinal cord and may help.

Detection
A congenital heart defect is often detected during a pregnancy ultrasound, according to information provided by healthline.
“If your doctor detects an abnormal heartbeat, for instance, they may further investigate the issue by performing certain tests such as an echocardiogram, a chest X-ray, or an MRI scan. If a diagnosis is made, your doctor will make sure the appro specialists are available during delivery,” it explains in part.

Symptoms
Dr Peter Lwabi, a paediatric cardiologist, says in some cases, the symptoms of a congenital heart defect may not appear until shortly after birth but newborns with heart defects may experience bluish lips, skin, fingers and toes and breathlessness or trouble breathing.
Others are feeding difficulties, low birth weight, chest pain and delayed growth.
In other cases, the symptoms of a congenital heart defect may not appear until many years after birth. Once symptoms develop, they may include abnormal heart rhythms, dizziness, trouble breathing, fainting, swelling, and fatigue.