Pediatric Cardiology division is relatively a new subspecialty of Cardiology. It is growing rapidly in our country for the last 2 decades. It mainly deals with diagnosis and management of Congenital and Acquired Heart Diseases in children including the fetus (the baby in the mother’s womb). Most of the babies are normal and healthy at birth. However, few babies are born with birth defects. Among these defects 30% are due to Congenital Heart Diseases. It accounts for approximately 8-10/1000 Live-births. It’s huge number and children with CHD become burden to the family, as the cost of treatment (Medical and Surgical) is available at limited centres and most of the centres are private hospitals. Hence, it would be beneficial to know about CHD during pregnancy itself. We need to know what is the problem with the baby in the womb, how far it is going to affect the life of the baby in future, what exactly is causing this problem, are there any treatment options that we could employ while baby is in the womb, is it associated with other birth defects etc. – in order to improve the overall outcome. Is the problem so severe that Medical Termination of Pregnancy is an option to consider?
To answer all these questions, we have a team of trained Congenital and Pediatric Cardiologists who can perform detailed Fetal Heart Scanning (Fetal Echocardiography). A good scan performed by a trained person between 16-20 weeks of pregnancy can identify 60-70% of the major cardiac malformations in the fetus. Fetal Echocardiography at this gestation, along with Anomaly scan and Serum biochemical tests done in our standard biochemical laboratory, can pick up almost 90% of the common Genetic abnormalities and Developmental malformations. It is very important that this Fetal heart scan is done by trained specialists.
We get a lot of referrals to our Pediatric cardiology division, once an anomaly scan shows some fetal abnormality during routine USG at the Primary care level. We perform a detailed fetal heart scan. We handle these cases with a Multidisciplinary approach. At times, we take an opinion from world class centers both inside and outside the country.
We have a support from Department of Fetal medicine and Medical Genetics – A world class diagnostic and research centre in our hospital. We also have support from a very good team of NICU, Pediatrics, Adult cardiology, Cardiothoracic & Vascular Surgery, Radiology and other specialties who are needed for the Multidisciplinary care of the children with CHD.
We are also supported by Perinatal autopsy plus advanced genetic testing performed by the department of Medical Genetics which helps in accurate diagnosis and assistance in counseling / management of future pregnancies. Coming to children with CHD we manage simple cardiac lesions in Cardiac Catheterization Laboratory (without Open Heart Surgery). We have very good Catheterization Labs which are well equipped and staff specially trained in cardiac procedures. We have a team of very eminent Pediatric Cardiac Surgeons and Pediatric Cardiac Anaesthetists who deal with complex CHD in children including neonates. We have very good support from NICU and Pediatrics to manage children with CHD, both during preoperative and perioperative period.
Dr. Akkatai S Teli