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What do I do if my baby has a heart defect?

Finding a heart defect before birth can affect your pregnancy care, delivery plans and whether doctors need to evaluated your baby for other health or genetic conditions.

Structural heart defects

Fetal echocardiography can help find heart problems before a baby is born. Knowing early helps plan for care and start treatment sooner after birth, if needed. For babies with serious heart defects, early diagnosis can improve care planning and may improve outcomes. A pediatric cardiologist will explain how serious the defect is and what to expect.

Some heart defects don’t need treatment right away. The baby can be cared for at the delivery hospital and followed closely after going home. Other heart defects are more serious and may require the baby to be moved to a hospital with pediatric cardiac surgical services soon after birth. In some cases, doctors may recommend delivering the baby at a pediatric heart center so treatment can begin right after birth. These plans are usually made during fetal echocardiogram visits.

Only a small number of heart conditions can be treated before birth with procedures such as fetal balloon interventions. These treatments are still specialized and are used in select cases, and outcomes can vary. Your pediatric cardiologist can:

• Explain whether your baby might be a candidate for treatment before birth
• Talk about possible benefits and risks for you and your baby
• Help refer you to a fetal intervention center if needed

Heart rhythm problems

A fetal heart rate can normally range between 110 and 160 beats per minute. It may speed up when the baby moves or during contractions, then return to normal. It is also common for the fetus to have an irregular heartbeat, often due to extra beats. Most of the time, this is harmless and goes away shortly after birth. If the irregular heartbeats happen frequently or in a regular pattern, doctors may recommend more testing.

More serious heart rhythm problems include tachycardia (heart rate that is too fast) and bradycardia (heart rate that is too slow). Fetal tachycardia is rare but can cause problems for both the mother and baby. Some babies are treated with medications given to the mother, which pass through the placenta to help control the baby’s heart rate. These medications can have side effects for both the mother and baby, so doctors monitor them closely.

Treatment for fetal bradycardia depends on the situation. Doctors may closely watch the baby for signs of distress. If a slow heart rate continues after birth, the baby will need careful evaluation and may require treatment.

If a heart rhythm problem is hard to control, your pediatric cardiologist will work closely with your obstetrician and maternal-fetal medicine specialist. Together they will weigh the risks and benefits of treatment, the risk of the rhythm problem continuing and the risk of early delivery.

Finding a heart rhythm problem before birth can also help families prepare. It gives you time to learn about the condition and what care your baby may need after birth. Many hospitals use a team-based approach to care. Your care team may include:

• Pediatric cardiologist
• Genetics counselor
• Obstetrician
• Maternal-fetal medicine specialist
• Neonatologist
• Nurse
• Social worker

Your care team will share information about your baby’s heart condition with your obstetrician and the doctors who will care for your baby after birth.