known about the various causes, for operating on a pregnant
woman, in the first three months of pregnancy, during which
period, development of the heart in the foetus is expected to be
complete.
Under the above circumstances, the best thing would be that all
pregnant mothers must undergo a routine ultrasonography, and if
some abnormality is suspected, foetal echocardiography must be
undertaken for the precise detection of congenital defect in the
heart. However, the question of termination of pregnancy must be
taken especially in consultation with a heart specialist, or one
who is dealing with pediatric cardiac surgery. Many of the
congenital lesions of the heart can be satisfactorily treated,
though surgically. All aspects of the case must be studied like
the number of children, and if the previous offspring have any
congenital defect or not, or, if this pregnancy has occurred
after a long period of time.
Heredity may play some role in the causation of the disease. If
the mother has any congenital defect in her heart, the chances,
though minimal, of a defect in the heart of the expected baby
may increase. Genetic counselling may help in such cases before
the pregnancy is planned.
There are some conditions worth mentioning which must be
avoided by a pregnant mother, as there are some likely factors
which may disturb the development of the heart in the foetus.
If the mother is diabetic, it must be properly controlled.
Diabetes, and even prediabetes, is known to cause congenital
defects in the heart. Similarly, if the mother is suffering from
epilepsy, the teratogenic effect of antiepileptic drugs must be
kept in mind. Therefore, in such cases foetal echocardiography
is a must to assess the condition of the heart. Exposure to X
rays/radiation should also be avoided.
All pregnant mothers, especially in the first three months of
pregnancy, must be prevented from contracting any viral
infection, particularly infection caused by the virus of German
measles. A good diet is also essential during pregnancy, and in
case the individual is taking alcohol, it must be stopped
altogether. It may not only cause a congenital defect in the
heart, it may also affect the general development of the foetus,
especially the brain.
A drug like thalidomide, which is a known teratogenic, and one
used in psychiatry, i.e. lithium, should also be stopped.
However, in spite of taking best possible precautions, the
child may still be born with some congenital lesion in the
heart. Therefore, as stated earlier; a routine ultrasonography
and if need be, foetal echocardiography, is a must for all
pregnant mothers in their first trimester. This will help them
know the exact position of the heart of the foetus they are
carrying and whether the pregnancy should be terminated, or
continued, though there may be a little congenital lesion in the
heart which can be treated/taken care of after the child is
born.
It may be concluded that although prescribed precautions must
be taken bya pregnant mother, yet detection of a lesion in the
heart of the foetus during the period of pregnancy, or after the
child is born, or during childhood (if the case has remained
undetected earlier), as well as timely treatment/ surgery, will
help a lot in improving the overall healthy span of life in such
cases. And for all this, a mass consciousness is essentially
required for successful completion of this aim.
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