With the implementation of the full liberalization of the two-child policy, many couples are ready to have another little one for their children, but did you know that with the increase in age, the quality of sperm and eggs will decline, especially in advanced maternal age, is an important factor in many congenital defect diseases, congenital heart disease is one of the categories, how to recognize congenital heart disease, understand its onset factors, prevention strategies, to have a healthy The following knowledge you should know about the second child baby.
1.Understanding congenital heart disease
Congenital heart disease is a congenital malformation caused by abnormal development of heart vessels during the fetal period, and it is the most common heart disease during the pediatric period. The emergence rate of congenital cardiovascular development malformations within 1 year after birth accounts for 4.05‰~12.3‰ of live births, and the incidence rate of premature infants is 2~3 times that of immature infants, thus it is projected that 100~150,000 new children with congenital heart disease will be added every year nationwide. If untreated, about 1/3 of the children die within one month after birth, which seriously affects the physical and mental health of children. In the past half century, due to the application of various cardiovascular examination techniques, especially color Doppler echocardiography, the development of deep hypothermia anesthesia and intracardiac surgery under extracorporeal circulation, and the progress of interventional treatment of precardial diseases, many precardial diseases can be diagnosed accurately in time and most of them can be completely cured. Some of the complex congenital heart diseases in the neonatal period can also be diagnosed and treated surgically in time, and overseas has developed to the successful implementation of surgery in the fetal period, so that the prognosis of congenital heart disease is greatly improved.
2.Classification of congenital heart disease
The traditional classification method mainly divides congenital heart disease into three groups according to hemodynamic changes.
(1) No shunt type (no cyanosis type) that is, no abnormal pathways and shunts between the left and right sides of the heart or between the arteries and veins, and no cyanosis is produced. It includes aortic constriction, pulmonary valve stenosis, aortic stenosis as well as pulmonary valve stenosis, simple pulmonary dilatation, and primary pulmonary hypertension.
(2) Left-to-right shunt group (latent cyanosis type) This type has abnormal passage between the left and right sides of the heart in the blood flow circulation pathway. In the early stage, because the pressure of the left side of the body circulation of the heart is greater than the pressure of the right side of the pulmonary circulation, the blood flow normally shunts from the left to the right without bruising. When the pressure in the pulmonary artery or the right ventricle increases and exceeds the pressure in the left side of the heart due to crying, breath-holding or any pathological condition, the blood can be shunted from the right to the left and temporary cyanosis can occur. Examples include atrial septal defect, ventricular septal defect, patent ductus arteriosus, main pulmonary artery septal defect, and aortic sinus aneurysm breaking into the right heart or pulmonary artery.
(3) Right-to-left shunt group (cyanotic type) The malformations included in this group also constitute anomalous traffic within the left and right cardiovascular cavities. The venous blood in the right cardiovascular cavity is shunted into the left cardiovascular cavity through the abnormal traffic, and a large amount of venous blood is injected into the body circulation, so persistent cyanosis may occur. Such as tetralogy of Fallot, triad of Fallot, double outlet of the right ventricle and complete transposition of the great arteries, permanent arterial trunk, etc.
3.The etiology of congenital heart disease
During the period of human embryonic development (within the first 2-3 months of pregnancy), the heart with local anatomical structure abnormalities caused by the formation disorders of the heart and large blood vessels, or the failure to close the channels that should close automatically after birth (which is normal in the fetus), is called congenital heart disease, and it is known that the occurrence of congenital heart disease is mainly related to the following factors.
(1) Chromosomal abnormalities and single gene mutations
Chromosomal abnormalities are numerical or structural aberrations caused by deletion, duplication or rearrangement of genetic material. Such chromosomal abnormalities cause about 5% of congenital heart disease and are often accompanied by malformations of organs other than the heart.
(2) Multifactorial inheritance
According to the data, it accounts for about 90% of congenital heart disease. If there is a congenital heart disease in the family of parents
If the parents have a family history of heart disease, coupled with environmental factors, such as viral infection in early pregnancy, radioactive pollution, exposure to pesticides, drug abuse, smoking and alcohol abuse, etc.. The incidence of congenital heart disease will be significantly higher if various factors interact with each other and affect the fetal heart development.
(3) The effect of pregnant women with diabetes on the fetus
In recent years, there have been new developments in research on pregnant women with diabetes, and it has been confirmed that the impaired glucose metabolism in pregnant women is one of the important causes of abnormal fetal heart development. The incidence of congenital heart disease in the fetus can be about 5% if diabetes is present before pregnancy.
(4) Viral infection
Viral infections in early pregnancy can cause malformations in embryonic heart development. The most common of these are rubella virus and coxsackie virus. Rubella virus is a round, tiny particle that is cold and heat resistant and is prevalent in the winter and spring. The virus can be exhaled from the patient’s mouth and nose, spread through the air and droplets, and can also infect others directly through the patient’s mouth, nose, and eye secretions. Since fetal organ development is basically completed within 8 weeks of gestation, rubella virus infection in early pregnancy can cause malformations in the fetal heart and eyes. The most common heart malformations are ductus arteriosus and pulmonary artery stenosis.
4.Prevention of congenital heart disease
In order to prevent the occurrence of congenital heart disease, attention should be paid to the mother’s health care during pregnancy, especially in the early stages of pregnancy, such as active prevention of rubella, influenza, mumps and other viral infections. Avoid exposure to radiation and some harmful substances. Use medications under the guidance of doctors and avoid taking drugs that have an impact on fetal development, such as anti-cancer drugs and methylglyoxal. Actively treat primary diseases, such as diabetes. Pay attention to reasonable diet and avoid nutritional deficiency. Prevent local mechanical compression around the fetus. In conclusion, in order to prevent congenital heart disease,
In short, in order to prevent congenital heart disease, all factors related to its development should be avoided.
5.What should I do if my baby has congenital heart disease?
If the above-mentioned unfavorable factors were encountered in early pregnancy, prenatal diagnostic tests can be performed between 6 and 20 weeks of pregnancy, commonly used are fetal electrocardiogram, fetal echocardiogram, and also amniocentesis to extract amniotic fluid for examination. Among them, echocardiography is the only safe and reliable means to visualize the structure of the heart and the hemodynamics within the heart and large blood vessels before delivery. However, a specialist cardiologist must be available to make an accurate diagnosis, and there is no need to be overly nervous once a fetus with congenital heart disease is detected prenatally. In fact, the majority of congenital heart disease is simple and curable, with the improvement of medical level, many children with congenital heart disease are living well after surgical treatment and have grown up to have a family. Only a very small percentage of children with complex congenital heart disease are recommended by doctors to terminate the pregnancy, however, this is done in consultation with a specialist congenital heart doctor. The actual situation is that many doctors lack sufficient knowledge about congenital heart disease, resulting in many simple congenital heart diseases being recommended for termination of pregnancy, which is very unfortunate and sad, after all, it takes a lot of energy, time and emotion to carry a baby, especially for older pregnant women.
In conclusion, taking care of prevention before pregnancy and enhancing perinatal care after pregnancy can greatly reduce the incidence of congenital heart malformations in children born with the disease. But good intentions do not always yield ideal results. In the unfortunate event that your baby is screened for suspected congenital heart disease, do not be pessimistic, let alone terminate your pregnancy on impulse, whether it is complicated or not. It is recommended to go to the Heart Center of the Third Affiliated Hospital of Zhengzhou University, which is a congenital heart disease treatment center in Henan Province with the best congenital heart surgery team, where you can get the most authoritative explanation of doubts, rational advice and professional treatment!