Heart Defects In Newborns

Heart defects in newborns affect approximately 8 out of every 1000 births.  Causes can include genetic factors, such as those found in Down’s syndrome, or factors due to the developing baby’s environment. Certain medications, such as Paxil (Paroxetine), Zoloft (Sertraline), Wellbutrin (Bupropion), or Prozac (Fluoxetine) may be associated with cardiac birth defects in the babies of mothers who took these medications when pregnant. While some heart defects may only slightly affect a child’s quality of life, others can be very serious and may require surgical correction. Although causes of many heart defects are not known, improvements in prenatal diagnosis has led to better management and outcomes for those babies affected by these conditions.

The most common way to diagnose a cardiac defect prenatally is by sonogram. Many obstetricians order a screening sonogram for their patients during the 16th to 20th week of pregnancy. Part of the standard practice for the sonographer is to identify the four chambers of the baby’s developing heart.

If the four chambers are not seen, or appear abnormal, a more specialized test, called a fetal echocardiogram may be ordered. This test involves a more detailed sonogram examination of the developing baby’s heart. Abnormalities can be further evaluated by this test method.

There are many different cardiac anomalies that affect newborns. Only three (3) will be discussed here:

Ventricular Septal Defect (VSD)- refers to a hole between the ventricles, the two lower chambersof the heart. The mixing of the oxygenated and deoxygenated blood through the defect can cause symptoms. Sometimes, a small VSD may close up on its own; sometimes surgery is required.

Atrial Septal Defect (ASD)- involves a hole in the wall separating the atria, the upper chambers of the heart.

Pulmonary Stenosis- occurs when the pulmonary artery that leads from the right ventricle to the lungs is narrowed. This can obstruct this crucial bloodflow out of the heart and can cause the right ventricle to become over developed and enlarged in trying to overcome the obstructive narrowing.

If proper prenatal testing was not done, or if testing was not read or interpreted properly, medical malpractice may have occurred.  Allegations of medical malpractice may include a negligent delay in diagnosis and/or inadequate surgical treatment and care of the newborn's heart defect.   Lawsuits may also result if a baby was injured by medications used by the mother. Cardiac defects can cause serious health problems in the child and may also involve major surgery for correction. In addition, complications can occur due to the defect, especially if undiagnosed. It is very important that women at risk for having a baby with a heart defect have appropriate screening tests done. Risk factors for congenital heart defects may include prenatal exposure to the medications listed above. Also, factors such as a sibling or family history of congenital heart defects may warrant increased surveillance and testing during the pregnancy.