Fetal and Perinatal Cardiology

The Fetal and Perinatal Cardiology Program at PHS diagnoses and treats:

• Arrhythmias (irregular heartbeats).


• Congenital heart defects in fetal development.

Our pediatric cardiologists can begin medical treatment even before delivery. Our goal is to facilitate the healthiest transition possible from fetal to newborn life.

Our department also offers fetal and perinatal echocardiograms after ## weeks’ gestation to evaluate fetal development.

Why choose Presbyterian for your fetal and perinatal cardiology?

Presbyterian’s Pediatric and Congenital Cardiology team has many different options to help you manage your or your child’s heart condition. The team performs various diagnostic tests and procedures to help form an accurate diagnosis and create individualized treatment plans. Depending on the type of heart condition your child has and its underlying cause, the team can recommend a wide variety of treatment options. Our pediatric cardiologists, pediatric interventional cardiologists, and pediatric cardiovascular surgeons work closely together for cases in which cardiac repair or surgery is the best treatment option.

Who is eligible for a fetal and perinatal cardiology?

The most common fetal and perinatal cardiovascular problems are congenital heart defects (CHDs). It is estimated that more than two million individuals in the United States are living with CHDs.

CHDs often cause a heart murmur that a doctor can sometimes hear using a stethoscope. To confirm the diagnosis, your doctor may order several tests, including:

• Echocardiogram: In this test, sound waves produce a video image of the heart. Doctors may use this test to diagnose a VSD and determine its size, location, and severity.


• Electrocardiogram (EKG): This test records the heart's electrical activity through electrodes attached to the skin and helps diagnose heart defects or rhythm problems.


• Chest X-ray: An X-ray image helps the doctor view the heart and lungs to see if the heart is enlarged and if the lungs have extra fluid.


• Cardiac catheterization: Through cardiac catheterization, doctors can diagnose congenital heart defects and determine the function of the heart valves and chambers.

What conditions can be treated with a fetal and perinatal cardiology?

The most common CHDs include:

• Aortic valve stenosis.


• Atrial septal defect.


• Atrioventricular septal defect


• Tetralogy of Fallot.


• Single ventricle defects.


• Patent ductus arteriosus.


• Ventricular septal defect.


• Patent foramen ovale.


• Pulmonary valve stenosis.


• Transposition of the great arteries.

Symptoms of these heart defects may include:

• Fainting.


• Irritability.


• A heart murmur.


• Poor weight gain.


• Prolonged crying.


• Bluish skin (cyanosis).


• Tiring easily during play or exercise.


• Clubbing of fingers and toes—an abnormal, rounded shape of the nail bed.


• Shortness of breath and rapid breathing, especially during feeding or exercise.

If left untreated, complications from a CHD can include:

• Heart failure: In a heart with a medium or large defect, the heart works harder, and the lungs have too much blood pumped to them. Without treatment, heart failure can develop.


• Pulmonary hypertension: Increased blood flow to the lungs due to a defect that causes high blood pressure in the lung arteries (pulmonary hypertension) can permanently damage them.


• Other heart problems: These include abnormal heart rhythms (arrhythmias) and valvular heart disease.

How do I prepare for a fetal and perinatal cardiology?

It is always important to have as much information as possible when you have a fetal procedure.

Routine preoperative care may include:

• Shaving of the abdomen.


• Antacids for heartburn.


• Thick elastic stockings.


• Drinking water and electrolytes.


• Not eating after midnight the day before the procedure.

What should I expect during my fetal and perinatal cardiology?

The anesthesiologist will monitor your heart in the operating room and control your breathing through a tube in your throat and airway. In many cases, general anesthesia is not required. The anesthesiologist will manage your pain and monitor your baby's heart rate during the surgery.

The perinatologist and OR (operating room) nurses will perform the operative procedure.

After surgery, you will be cared for in the obstetrical department.

The amount of time you will spend in the hospital is dependent on the type of procedure you had. If the operation is done with small incisions, you may only be in the hospital overnight. If the operation requires a large incision, you may be in the hospital for several days.

How do I care for myself after my fetal and perinatal cardiology?

Guidelines for post-surgical care will vary depending on the operation.

• Activity: Restrictions on your activity are dependent on the type of procedure you had and your condition after surgery. You may need to be on bed rest for many weeks. Your doctor will be more specific.


• Eating: Since your activity is decreased, you may not feel like eating. You will be given guidance on diet. It may be six small meals a day and eight glasses of water a day to prevent constipation.


• Medications: You may be on tocolytics until 37 weeks gestation. You should bring your prenatal vitamins and begin retaking them after discharge.


• Exercise: You will receive instructions for bed rest exercises. The most important exercise is flexing your foot towards your head and then pointing it. Do the bedrest exercises as often as you can.

You will see the perinatologist once per week. You may have an ultrasound at least once per week.