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Pregnancy Complications (VSD, SUA)
Ashirus wrote:
Hi. My wife is pregnant with her first child. I'm 22, she's 20, she's now in her 30th week and the 21st wk ultrasound found that she has a single umbilical artery (SUA) and so we were told to get a foetal echocardiography. This was performed yesterday and the foetus was discovered to have 2 to 3 Ventricular Septal Defects (VSD) of "small-to-moderate" size: to quote the relevant bit of his report: "Normal right and left ventricular size and function, 2-3 muscular VSDs - A 3mm apical, 2mm mid-muscular and possibly another 1mm mid-high muscular VSD. 6MMHG shunt is seen (no PS)." the rest of his report reports everything's fine. The doctor said that this may be a sign of one of the "syndromes". The 21st week ultrasound revealed no other defects or deformities, so we want to know what the chances of the child being born being with a syndrome is, given these factors? Is the doctor right? Should we worry? Does anyone know the chances of this number (2-3) of defects of these sizes at this "age" closing spontaneously either before or after birth? Without doing a lot more looking, I can't give you a number. SUA and VSD *are* associated with an increased risk of certain trisomies (though not so much trisomy 21, which is Downs Syndrome). However, more babies with either of those conditions do *not* have chromosomal problems. VSD is among the most common cardiac complications in otherwise normal babies. A good two thirds of babies with SUA have no other complications. Whether you should worry or not is probably a moot question, as I suppose it's nearly impossible *not* to worry to some degree! I certainly wouldn't panic, though. Best wishes, Ericka |
#2
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Pregnancy Complications (VSD, SUA)
"Ericka Kammerer" wrote in message ... Ashirus wrote: Hi. My wife is pregnant with her first child. I'm 22, she's 20, she's now in her 30th week and the 21st wk ultrasound found that she has a single umbilical artery (SUA) and so we were told to get a foetal echocardiography. This was performed yesterday and the foetus was discovered to have 2 to 3 Ventricular Septal Defects (VSD) of "small-to-moderate" size: to quote the relevant bit of his report: "Normal right and left ventricular size and function, 2-3 muscular VSDs - A 3mm apical, 2mm mid-muscular and possibly another 1mm mid-high muscular VSD. 6MMHG shunt is seen (no PS)." the rest of his report reports everything's fine. The doctor said that this may be a sign of one of the "syndromes". Well, the doctor is right. It *MAY* be a sign of one of the "syndromes". But then again, maybe it's just a simple congenital/developmental defect. Let me tell you my story: When I was pregnant with my twins, at about 18 weeks (I was being followed very closely), my smaller twin was discovered to have an SUA and a heart defect. The perinatologist went (in the course of one conversation) from telling me it *could* be a sign of a genetic defect (syndrome) to "Yes, it probably is." Then she suggested that in our situation, some people would choose to abort the pregnancy. I was unhappy about this. When my twins were born, yes the one with the SUA and the heart defects was sick. Yes she spent a lot of time in the hospital, and yes she had heart surgery (at the age of 4 months). But she does not have any genetic defects, and you couldn't tell by looking at her (clothed) that she was ever a sick baby. (Naked, of course, she has her surgery scars.) And I'm still irritated about the whole 'could be' -- 'must be' -- 'you might want to abort' progression. It was not based on any evidence at all. If you're worried enough about a syndrome, and you're willing to take the risks associated with an amniocentesis, they can rule out genetic defects definitively for you. Or you can wait, and take what comes, and love your little girlie for everything she's worth. --angela |
#3
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Pregnancy Complications (VSD, SUA)
"Ericka Kammerer" wrote in message
... Ashirus wrote: Hi. My wife is pregnant with her first child. I'm 22, she's 20, she's now in her 30th week and the 21st wk ultrasound found that she has a single umbilical artery (SUA) and so we were told to get a foetal echocardiography. This was performed yesterday and the foetus was discovered to have 2 to 3 Ventricular Septal Defects (VSD) of "small-to-moderate" size: to quote the relevant bit of his report: "Normal right and left ventricular size and function, 2-3 muscular VSDs - A 3mm apical, 2mm mid-muscular and possibly another 1mm mid-high muscular VSD. 6MMHG shunt is seen (no PS)." the rest of his report reports everything's fine. The doctor said that this may be a sign of one of the "syndromes". The 21st week ultrasound revealed no other defects or deformities, so we want to know what the chances of the child being born being with a syndrome is, given these factors? Is the doctor right? Should we worry? Does anyone know the chances of this number (2-3) of defects of these sizes at this "age" closing spontaneously either before or after birth? Without doing a lot more looking, I can't give you a number. SUA and VSD *are* associated with an increased risk of certain trisomies (though not so much trisomy 21, which is Downs Syndrome). However, more babies with either of those conditions do *not* have chromosomal problems. VSD is among the most common cardiac complications in otherwise normal babies. A good two thirds of babies with SUA have no other complications. Whether you should worry or not is probably a moot question, as I suppose it's nearly impossible *not* to worry to some degree! I certainly wouldn't panic, though. Best wishes, Ericka I'm not sure about other trisomies, but VSD is definitely assocated with Down syndrome; approximately 50% of kids with DS have a heart defect. But probably only a small percentage of kids with VSDs have Down syndrome just because the occurrence is not that high. Most common in DS is an AVSD which is also known as an endocardial cushion defect but in my daughter's case, she had 2 ASDs and 1 VSD, all small. Last summer (when she was 4yo) we elected to go ahead and have them fixed rather than wait until she started showing signs of heart failure. It's amazing what pediatric heart surgeons can do -- she went in on a Thursday morning and was discharged by noon on Saturday. It was almost embarassing to come into the PICU on Friday morning and find her laughing, playing and watching Sesame Street sitting in a nurse's lap while other kids were hooked up to all sorts of tubes, wires and monitors. She probably could have been discharged directly from the PICU. Within a week, we were at the pool (they used skin glue to close the main incision and a few stiches to close where the chest drainage tube was removed). If anyone *ever* needs a recommendation for a ped heart surgeon, I'd definitely recommend Dr Jaggers at Duke University Med Ctr! From what I understand, too, fixing just a VSD is often easier and can be done without a chest incision by threading the tiny instruments up through the artery in the groin (like a heart catheterization) to close the holes up. (ASDs can't be reached that way). Depending on your location, you might want to have an amnio just to be prepared by choosing a hospital with a critical care nursery with specialists on hand in case of complications. Leigh in raLeigh |
#4
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Pregnancy Complications (VSD, SUA)
Leigh Menconi wrote:
I'm not sure about other trisomies, but VSD is definitely assocated with Down syndrome; approximately 50% of kids with DS have a heart defect. But probably only a small percentage of kids with VSDs have Down syndrome just because the occurrence is not that high. Sorry--I should have been more clear. VSD is associated with DS, just as you say. The *combination* of SUA and VSD is not so much associated with DS, though it is associated with other trisomies. However, the occurrence of those other trisomies is even lower that of DS, and the majority of babies with SUA and VSD are fine chromosomally, if that makes sense ;-) Best wishes, Ericka |
#5
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Pregnancy Complications (VSD, SUA)
Leigh Menconi wrote:
I'm not sure about other trisomies, but VSD is definitely assocated with Down syndrome; approximately 50% of kids with DS have a heart defect. But probably only a small percentage of kids with VSDs have Down syndrome just because the occurrence is not that high. Most common in DS is an AVSD which is also known as an endocardial cushion defect but in my daughter's case, she had 2 ASDs and 1 VSD, all small. Last summer (when she was 4yo) we elected to go ahead and have them fixed rather than wait until she started showing signs of heart failure. It's amazing what pediatric heart surgeons can do -- she went in on a Thursday morning and was discharged by noon on Saturday. It was almost embarassing to come into the PICU on Friday morning and find her laughing, playing and watching Sesame Street sitting in a nurse's lap while other kids were hooked up to all sorts of tubes, wires and monitors. She probably could have been discharged directly from the PICU. Within a week, we were at the pool (they used skin glue to close the main incision and a few stiches to close where the chest drainage tube was removed). If anyone *ever* needs a recommendation for a ped heart surgeon, I'd definitely recommend Dr Jaggers at Duke University Med Ctr! To the original poster, definately seek out a pediatric cardiologist, and if needed a pediatric cardiovascular surgeon. Even if it means travelling, they know how to fix these things and are used to doing it on little kids and babies. I would likely seek out a children's hospital too - anestheseologists and perfusionist used to working on kids. From what I understand, too, fixing just a VSD is often easier and can be done without a chest incision by threading the tiny instruments up through the artery in the groin (like a heart catheterization) to close the holes up. (ASDs can't be reached that way). Other way around, I believe. An ASD (atrial septal defect) can be reached by catheters. I think some VSDs can be fixed with catheters, but VSD repair is usually open heart. Additionally, muscular VSDs are more likely to close on thier own than membranous VSDs. But the OP really will need to talk to a pediatric cardiologist (or two) about the likelihood of them closing. And it seems as though early repair of these defects is becoming more standard of care. Leigh is right, its amazing how quickly kids bounce back from these types of repair surgeries. Mary |
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