Neonatal Cardiac Services

Congenital heart defects in newborns can occur during foetal development when the blood vessels and heart fails to develop. Congenital heart defects in neonates stem from genetics with more than ten per cent of cases being genetically attributed. Babies born with Down syndrome are likely to suffer from malformations of the heart, more commonly from Atrioventricular Septal Defect, also referred to as Endocardial Cushion Defect that involves an additional chromosome, or trisomy 21.

Failure to screen for rubella during a prenatal test increases the risk of the development of congenital heart defects in newborns. A rubella infection within the early stages of pregnancy from week eight to ten can cause multiple congenital disabilities and congenital heart disease.

Poorly managed diabetes and nutrition during pregnancy increase the risk of congenital heart defects in babies. High levels of insulin in the blood interfere and disrupt the healthy development of the foetus. Women with elevated glucose values are more likely to give birth to babies with congenital heart defects. Tetralogy of Fallot or blue baby syndrome occurs when there's a structural malformation in the heart as well as blood vessels connecting the heart to the lungs, restricting oxygen levels. Significantly high levels of insulin in pregnant mothers can cause the repositioning of two main arteries of the heart, preventing the circulation of oxygenated blood from the lungs leading to dextro-transportation of the great arteries.

How are congenital heart defects in newborns diagnosed?

Dr Jiyana utilises echocardiography to examine the interior of the heart to detect any heart problems that foetal echocardiography fails to pick up. Dr Jiyana carries out echocardiography that utilises sound waves to recreate images of the heart combined with a Doppler test using sound waves to measure the direction and speed of blood flow diagnosing cardiac issues, and guiding heart surgery as well as cardiac catheterisations.

Dr Jiyana carries out a cardiovascular diagnostic angiography to examine and check for narrow or blocked blood vessels in the heart. The doctor injects a special dye visible by X-ray into the blood vessels of the heart. The X-ray captures a series of angiograms and corrects clogged heart arteries by angioplasty during the diagnostic test.

How are congenital heart defects in newborns treated?

A balloon Septostomy treats transposition of the great vessels during the first two weeks after birth by enlarging the opening between the atria for more oxygenated blood to reach the body. When the aorta, the primary artery of the body becomes pinched, the blood pressure in the lower body is lower than usual. A pinched aorta needs to be treated in early infancy before the condition becomes severe. In much older children, the pinched section is stretched using stents or special balloons. Treatment for tetralogy of Fallot involves closing the septal defect and removing the obstruction of blood flow from the right ventricle. In infants with severe symptoms, Dr Jiyana works closely with a cardiothoracic surgeon to perform a shunt procedure to increase the blood flow to the lungs, relieving the bluish colour of skin and lips from cyanosis.