Fetal Cardiology Division
1 Doctors
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The fetal cardiology division at Amrita Hospital, Kochi was launched in January 2008. The aim of this service is to create awareness among the medical community regarding the need and potential benefits of prenatal diagnosis of birth defects of the heart. This will provide the concerned families with more options for management rather than facing the trauma of taking a decision after the baby is born. The concept of prenatal diagnosis and planned peri-partum care for fetuses with critical heart defects was pioneered by us in India and South Asia. The division is very active academically and has been instrumental in the training of healthcare professionals in fetal heart evaluation globally and offered training courses and fellowships in fetal cardiology for doctors (both in-person and online). The division has published several important research papers in the field of Fetal Cardiology in various peer reviewed national and international journals. The division is spearheaded by Prof. Balu Vaidyanathan, who is renowned globally for his contributions to the field of Fetal Cardiology.
Fetal Cardiology Division,
Department of Pediatric Cardiology
Amrita Hospital, Kochi, Kerala, India
Telephone: 0484 -2853570; Fax: 0484 – 2802020.
Email: [email protected]; [email protected]
Dedicated on-call mobile/Whatsapp: +91 7994 999 773 (for appointments)
Fetal echocardiography is a highly specialized form of antenatal scan where a detailed evaluation of the unborn baby’s heart is carried out. This enables diagnosis of various forms of birth defects of the heart (congenital heart defects) and heart beat disorders (rhythm problems) in the fetus.
The principle of ultrasound scan is used for this technique. A minimum requirement for screening the fetal heart is a combination of 4 chamber view (heart chambers, valves and partitions), outflow tract view and 3-vessel view (blood vessels) which enables most of the cardiac defects to be detected. A detailed fetal echocardiography requires a thorough knowledge about the various types of birth defects of the heart and what all treatment can be offered including the costs involved. Few centers in India have a specialized fetal cardiology unit that provides a comprehensive facility for diagnosis, counseling and then treatment for various birth defects of the heart.
The ideal timing of fetal heart scan would be around 18-20 weeks. It is preferable to conduct these scans sufficiently early in pregnancy, so that if a problem is diagnosed, the family can be offered all possible options for management. Table 1 summarizes indications for fetal heart scan.
Fetal echocardiography uses the common ultrasound principle and it has been shown without any doubt that this is very safe, even if performed multiple times, in pregnancy.
Pre-natal diagnosis offers a much wider options to the expectant family, especially in the setting of developing countries with limited resources to treat complex heart defects.
Early diagnosis of very complex cardiac defects and multi-system disorders (cardiac defects with associated anomalies like genetic disorders) offers families the option of medical termination of pregnancy. This maybe a practical approach for very complex defects that can only be offered palliative procedures after birth with sub-optimal long-term outcomes.
Pre-natal diagnosis may possibly improve the post-natal outcomes of infants with critical but correctable heart defects (Eg: transposition of great arteries (TGA) or duct dependent conditions) by in-utero transport to a pediatric cardiac facility. Our data shows the dual benefit of improved neonatal outcomes along with cost savings for such critical defects.
Certain forms of heart defects (especially heart beat problems) can be offered in-utero treatment ( trans-placental therapy) with excellent outcomes to the fetus.
A multi-disciplinary approach is required to provide an adequate counseling and then to manage the condition through the perinatal period. All these services are provided by the Fetal cardiology Division at AIMS (see picture below).
