1.Why does the child suffer from congenital heart disease when both parents do not have congenital heart disease?
The pathogenesis of congenital heart disease is complex and inconclusive, but the general view is that it is the result of the interaction of genetic and environmental factors, of which the genetic correlation is about 55%. According to relevant data, genetics alone accounts for 8%, environment alone accounts for 2%, and genetic and environmental interactions account for 90%. Known risk factors include: viral infection in early pregnancy, altitude, nutritional deficiencies during pregnancy, lesions of the amniotic membrane, fetal compression, preeclampsia in early pregnancy, diabetes, hypercalcemia, the use of radiation and cytotoxic drugs in early pregnancy, and the mother’s advanced age. As for the genetic aspect, congenital heart disease has a tendency to develop in families to a certain extent, but according to the current theory of genetics that congenital heart disease is formed by the interaction of multiple genes and environmental factors, it can be said that parents with congenital heart disease do not directly cause their children to get the disease. Generally speaking, if one of the relatives has congenital heart disease, the chance of the others having the disease increases three times (3%), if two members have the disease, the chance increases to 9%, and if three members have the disease, the chance of the others having congenital heart disease increases to 50%.
2. Why do children with congenital heart disease grow smaller than other children?
In children with left-to-right shunt type of congenital heart disease, such as ventricular septal defect, atrial septal defect, arteriovenous ductus arteriosus, etc., there is left-to-right shunt at the level of the heart or aorta, and some blood is shunted from the body circulation system to the pulmonary circulation, resulting in a lower volume of blood in the body circulation than normal, which in turn affects the blood supply to the organs of the whole body, thus leading to growth restriction. For children with cyanotic precocious heart disease, growth and development will be affected because of the obvious lack of oxygen to the whole body.
3.Can precocious heart disease heal itself? Is it possible without surgery?
For ventricular septal defects less than 5mm in diameter, located in the perimembranous or myocardial region, secondary foramen ovale septal defects, and arteriovenous ductus arteriosus with a small diameter, there is a possibility of self-healing and surgery can be avoided, but only if the presence of this heart malformation does not have a significant impact on the growth and development of the child. Therefore, parents are asked to review the defect periodically while waiting, for two purposes: first, to detect whether the size of the defect tends to decrease, and second, to observe whether there are complications such as enlarged heart and increased pulmonary artery pressure. If the size of the defect is not decreasing and the pulmonary artery pressure is increasing, there is no point in waiting and surgery is needed as soon as possible.
Approximately one half of all children with precordial disease die within the first year of life due to severe cardiac anomalies. Survivors develop recurrent respiratory infections and developmental disorders at all ages of their growth and development. If left untreated, it will eventually lead to pulmonary hypertension, heart enlargement, heart failure, some complications of endocarditis, embolism, hemorrhage, hypertension, life-threatening, and a heavy mental and economic burden to the family.
4.When is the right time for surgery?
For the treatment of congenital heart disease, the consideration of age factor is one aspect, but more importantly, it is a comprehensive consideration based on the type of lesion, the development of the disease and the impact on the developmental status of the child. In this issue, it is important to follow the advice of a specialist. After the diagnosis of a child with precordial heart disease, some parents think that the child is too young to withstand the trauma of surgery and that it is safer to wait until the child is older before performing surgery, thus delaying the disease and losing the opportunity for surgery, resulting in lifelong regrets.
With the development of modern medical technology, the operation time of heart disease can not be determined by the size of the age, but should be based on the specific condition of the patient, especially some complex congenital heart disease, for these children life and treatment time is calculated in “hours”, such as complete transposition of the great arteries, must be operated after birth, otherwise the child will Otherwise, the child will die suddenly or lose the opportunity for corrective surgery. In addition to complex precordial diseases such as complete transposition of the great arteries, some children’s lives are measured in months, such as large ventricular septal defects, and if surgery is not performed in time, the child’s development will be affected by recurrent heart failure and lung infections, and severe pulmonary hypertension will occur and the opportunity for surgery will be lost. In addition, in children with tetralogy of Fallot, severe hypoxia can affect the function of the child’s vital organs, and even a single episode of severe hypoxia can endanger the child’s life. For example, ventricular septal defect and atrial septal defect with a diameter of 0.5 cm or less have a small impact on the growth and development of the child and can be treated without surgery for the time being, but must be observed regularly and follow the advice of professional doctors, and surgery can be scheduled according to the growth and development of the child and the disease. The treatment.
5.What are the symptoms of early precordial disease?
The symptoms of congenital heart disease may vary depending on the degree of malformation and age. Common clinical manifestations include.
Cyanosis: Cyanosis is a prominent manifestation of cyanotic congenital heart disease (e.g., large vessel misalignment, tetralogy of Fallot, etc.). It can persist after birth or become apparent gradually three to four months after birth, and is most obvious in the lips of the mouth, the beds of the finger (toe) nails, and the tip of the nose. In contrast, latent cyanotic heart disease (such as ventricular septal defect, atrial septal defect, and patent ductus arteriosus) usually does not have cyanosis, but only appears when moving, crying, holding one’s breath, or suffering from pneumonia, and persistent cyanosis can appear when pulmonary hypertension and right heart failure occur in late stages.
Heart murmur: Most congenital heart disease can be heard as a murmur, which is relatively loud and rough and can be accompanied by tremor in the anterior chest area in severe cases. Most heart murmurs are detected by the physician at the time of the visit. Some normal children may have a physiological murmur.
Poor physical strength: Due to poor cardiac function, insufficient blood supply and hypoxia, seriously ill children have feeding difficulties in infancy, stopping after a few sips, shortness of breath, easy vomiting and profuse sweating, prefer to be held vertically, older children are reluctant to move, prefer to squat, easy fatigue after activity, paroxysmal dyspnea, severe hypoxia often faints suddenly when nursing, crying or stooling, and are prone to heart failure.
The two are often the cause and effect of congenital heart disease and become the cause of death in congenital heart disease.
In addition, if the left atrium of congenital heart disease is enlarged or the pulmonary artery compresses the recurrent laryngeal nerve, the cry is hoarse, easy to shortness of breath and cough since childhood; it can be combined with other malformations, such as congenital cataract, cleft lip and palate and congenital stupidity, etc.; the enlarged ventricle can cause bulging of the precordial area and thoracic deformity; persistent cyanosis can be accompanied by pestle finger, which is mostly formed 1 to 2 years after the appearance of cyanosis.
6.What tests are needed to confirm the diagnosis of congenital heart disease?
Congenital heart disease needs to be diagnosed based on medical history, symptoms, signs and results of auxiliary examinations. Most of the children have heart murmurs on physical examination, and some of them have been diagnosed due to reduced crying and cyanosis, etc. There are even children with vascular rings who cannot be diagnosed due to long-term coughing and wheezing and have their heart malformations detected by cardiac ultrasound. At present, cardiac ultrasound can clearly diagnose most congenital heart diseases, and auxiliary examinations can include chest X-ray and electrocardiogram, which are mainly used to observe the development of pulmonary vessels and the size of each atrium. With the development of 64-row CT technology, enhanced CT can clearly diagnose congenital heart disease, but because of the danger of receiving radiation and because cardiac ultrasound can meet most of the clinical needs, only some congenital diseases require further enhanced CT examination, such as severe tetralogy of Fallot for the observation of pulmonary vascular development and collateral vessels, and complete pulmonary venous ectopic drainage for the observation of pulmonary venous return path and the presence of obstruction. The presence of obstruction can be observed. Similarly, cardiovascular angiography can also diagnose congenital heart disease, but because it is invasive and requires radiation, it is currently used only in special cases such as when pulmonary artery manometry is required.
7.What do I need to pay attention to before the procedure? How to perform daily care?
Try to keep the child quiet, avoid excessive crying, and ensure sufficient sleep. Older children should have a regular life, combining movement and stillness, neither running around outside (running and jumping and strenuous exercise are strictly prohibited), nor do they need to lie in bed all day, and sleep must be guaranteed at night to reduce the burden on the heart. Children with cardiac insufficiency tend to sweat more, so they need to keep their skin clean, bathe regularly in summer, rub themselves with hot towels in winter (pay attention to keeping warm), and change their clothes and pants regularly. Feed more water to ensure adequate hydration. Keep the stool smooth, if the stool is dry and difficult to defecate, excessive force will increase the abdominal pressure, increasing the burden on the heart, and may even have serious consequences. The child should eat less and more meals, ensure sufficient intake of protein and vitamins, and give as diverse and easily digestible diet as possible. Keep air circulation in the room and avoid crowded public places to reduce the chance of respiratory infection. Add and remove clothes in time with the weather and pay close attention to the prevention of colds. Regular follow-up visits to the cardiology clinic of the hospital and strict compliance with medical prescriptions, especially for cardiac and diuretic drugs, due to their pharmacological properties, the dosage must be absolutely controlled and taken on time and according to the course of treatment to ensure their efficacy. Before each dose of cardiac drugs, the pulse count should be measured, and if the heart rate is too slow, the drug should be stopped immediately to prevent toxic effects from occurring and endangering the child’s life.
For children who need to wait for surgery due to age or other factors, pay attention to prevent colds, develop brushing habits and maintain oral hygiene. Tooth decay and tonsillitis should be actively treated when found. If there is a long-term fever that does not subside, consult a physician as early as possible and avoid strenuous physical activities to avoid increasing the burden on the heart and lungs
8.Does the surgery have to be open?
When cardiac surgery first started, all congenital heart disease treatment required open surgery, but now with the development of science and technology, some congenital heart disease treatment can be carried out by interventional treatment. What is interventional therapy? In layman’s terms, interventional treatment of congenital heart disease is a treatment between medicine and surgery, which can also be understood as the treatment of congenital heart disease without surgery. It is a treatment method to cure congenital heart disease by using a catheter to deliver the necessary devices to the heart abnormality through the femoral artery or vein under the fluoroscopic view of a large X-ray machine. Although interventional treatment has the advantages of less trauma, faster recovery and shorter hospital stay, only a portion of congenital heart diseases can be treated with interventional treatment due to the limitations of operation techniques, methods and treatment devices. Therefore, the congenital heart diseases that can be treated by interventional methods have strict surgical indications, and the choice of surgical methods needs to be made according to the advice of a specialist.
9.What kind of congenital heart disease can be treated by interventional methods?
Although interventional treatment of congenital heart disease has many advantages, only some congenital heart diseases can be treated by interventional treatment due to the limitation of operation technology, method and treatment equipment. For example: congenital heart disease arteriovenous ductus arteriosus, pulmonary valve stenosis, pulmonary arteriovenous fistula; partial atrial septal defect, ventricular septal defect, coronary artery fistula, aortic stenosis, pulmonary artery stenosis and limb vascular malformation, etc. The extremely indications for the interventional treatment of precordial disease commonly performed in the clinic include
Arteriovenous ductus arteriosus: all types of left-to-right shunted arteriovenous ductus arteriosus that are ≥3 months of age and weigh 3 kg or more and are not combined with a cardiac malformation requiring surgical treatment. Caution must be exercised in infants and children with severe pulmonary hypertension, and surgical treatment should be chosen for children with an internal diameter greater than the internal diameter of the aorta in order to achieve a safer and more reliable result.
Atrial septal defect: age ≥3 years; diameter ≥5 mm with increased right heart volume load, ≤36 mm secondary foramen ovale type left-to-right shunt atrial septal defect; distance from the edge of the defect to the coronary sinus, superior and inferior vena cava and pulmonary veins ≥5 mm, distance from the atrioventricular valve ≥7 mm; diameter of the atrial septum is larger than the diameter of the selected blocking left atrial lateral parachute; no other cardiac malformation requiring surgery; surgical postoperative residual shunt.
Ventricular septal defect: (1) Diameter of defect: the diameter of the left ventricular surface of the perimembranous defect is 3-12mm; if the right ventricular side is porous, the diameter of its large hole should be greater than 2mm; if it is accompanied by concurrent membrane tumor, the diameter of the left ventricular surface of the defect is 13-18mm as a relative indication, and the right ventricular surface of the exit is required to be small and its adhesion is firm. (2) The distance of the defect edge of the perimembranous part from the right coronary valve of the aorta: eccentric blocker >1.5mm, symmetric blocker >2.0mm.(3) The distance of the defect edge from the right atrioventricular valve: eccentric blocker >2mm, symmetric blocker >1.5mm.(4) Combined with other cardiovascular malformations that can be treated by intervention. (5) Residual leak after surgical procedure. (6) Mild to moderate pulmonary hypertension without right-to-left shunt. (7) Myocardial ventricular septal defect combined with acute myocardial infarction or trauma-induced myocardial ventricular septal defect. (8) Age greater than 3 years and weight greater than 10 Kg.
10.What is the difference between interventional surgery and open surgery? What are the advantages and disadvantages of each?
Traditional surgical open-heart surgery is the main treatment modality, which is generally applicable to all simple and complex precordial diseases. Except for a small number of procedures such as ductus arteriosus and aortic constriction, most open surgery for precardiac disease requires the support of extracorporeal circulation. Compared with other surgical procedures, open heart surgery is less expensive and the hospital stay is about 7-10 days, but the surgery is more traumatic than other methods and the postoperative recovery is slower.
Interventional occlusion is a new type of minimally invasive treatment developed in recent years, which has fewer complications, less trauma, no need for open-heart surgery, fast recovery, no scarring, less patient pain and shorter hospital stay, but it has more strict indications and higher cost compared to surgical procedures.
Surgical minimally invasive blocking is also a new technique emerging in the last two years, which does not require opening the chest, but cutting a small 2-3 cm opening in the right anterior sternum, placing a pusher, and releasing the blocker to block the gap under the guidance of cardiac ultrasound. It avoids both extracorporeal strikes, reduced surgical incisions, and radiation during traditional interventional treatment; however, it has the disadvantages of both the incision of open surgery and the high cost of interventional treatment.
The specific surgical method to be used should be decided according to the indications and contraindications of various surgical methods and the economic situation of parents.
11.After the interventional procedure, will the blocker fall off? What are the complications?
One month after the blocker is implanted in the heart, the body’s own endothelial cells cover its surface, and after 3 months, the endothelial cells completely encapsulate and fix the blocker. Therefore, we require children to avoid strenuous exercise for 3 months after the intervention for precordial disease. After more than 10 years of follow-up observation, patients with congenital heart disease treated with interventional therapy are completely restored to health, their growth and development are not affected, and they are able to work, study and live like healthy people; marriage and childbirth are not affected.
The common complications of interventional treatment are as follows.
Intraoperative: when blocking a larger internal diameter arterial catheter failure, such as repeated multiple releases and retrievals of the blocking parachute may cause pulmonary artery entrapment; for severe pulmonary valve stenosis, spasm of the right ventricular outflow tract is likely to occur during balloon expansion, causing increased hypoxemia in severe cases; during interventional treatment of balloon pulmonary valvuloplasty and ventricular septal defect, there is a risk of damage to the tricuspid tendon to occur significant tricuspid regurgitation. Some children are also found to have dislodged blockers immediately after surgery, before they get off the operating table. The current level of technology has basically eliminated the possibility of serious complications such as cardiac rupture.
Postoperatively, complications such as dislodgement of the blocking device, residual shunt and hemolysis, which occurred in the early stage of arteriovenous catheter occlusion, are decreasing; in the past few years, we found that a very small number of cases after the placement of atrial blocker could cause perforation of the top of the left or right atrium, resulting in pericardial pressure and subsequent hemodynamic effects, and a very small number of patients had aortic perforation, and sometimes acute hemolysis could appear in the weeks after surgery. The perforation of the left atrium and aortic root is now thought to be related to the erosion of the atrium and aortic wall by the atrial defect occluder. It should be noted that atrial defect closure is safe and the risk of erosion of the plugger is minimal, with an incidence of 0.1%, all occurring in patients with anterior or anterosuperior border shortage of atrial defects, and the site of erosion is located at the top of the left or right atrium, and the need for regular follow-up after interventional treatment needs to be emphasized.
12.As the child grows up, can the surgical patch grow with it? Will they fall off?
Most of the patches used in precardiac surgery are treated autologous pericardial, polyester or Goretex patches. Regardless of the patches used, they do not have the ability to grow. Although the patch does not have the ability to grow, the growth of the cardiac structures surrounding the patch is not affected and, therefore, does not affect the enlargement of the heart with age. The autologous pericardium is easy to cut, histocompatible, less prone to thrombus formation, and easy to surgically close. Pericardial patches are often used for atrial and ventricular septal defects. Polyester sheets have the advantage of being an abundant source of material and are hard and do not oscillate easily with blood flow, and many repairs are made with polyester sheets. Although polyester sheets are foreign bodies, there is rarely significant blood disruption or thromboembolism, and over time after surgery, autologous cells will overlay the polyester sheet and become integrated with the surrounding tissue.
13 Is the surgery for precordial disease risky? Are there any after-effects after the surgery?
First of all, it should be noted that there are risks in any surgery. Heart surgery is a difficult surgery because it requires extracorporeal circulation support and intraoperative cardiac arrest, therefore, the risks of surgery are also greater than those of other specialties. However, with the improvement of the overall academic and technical level of cardiac surgery, this surgery has become routine in hospitals where cardiac surgery is routinely performed, and the risk of surgery is relatively low. Nevertheless, surgical treatment of precardiac disease is still subject to complications such as anesthesia accidents, extracorporeal circulation accidents (including air embolism, thrombosis, cardiac arrest, etc.), drug allergy, coagulation mechanism disorders, pericardial tamponade, internal environmental disorders such as water, electrolytes and metabolism that are difficult to correct, hoarseness, choking, celiac disease, residual shunts, regurgitation of each valve, various severe arrhythmias, and atrioventricular block. The chance of these surgical complications is very small, but as long as there is a possibility of them occurring, the surgeon will confide in the parents of the child before surgery.
14.What is Law 4? What do I need to be aware of before surgery?
It consists of four malformations: ventricular septal defect, pulmonary stenosis, aortic span and right ventricular hypertrophy, which may be combined with other malformations such as atrial septal defect and patent ductus arteriosus. The clinical manifestations include cyanosis (cyanosis) of the lips, fingers and toes, and the widening and thickening of the ends of the fingers and toes that resemble drumsticks. Some children with severe cyanosis may suddenly become irritable after crying, with increased cyanosis, difficulty in breathing, or even seizures or confusion, which is medically known as hypoxic attack, a dangerous condition that requires emergency treatment. When the child grows up and starts to walk, he often likes to squat and rest after walking a few steps; or he often takes a squatting position to talk with children, which are all clues with diagnostic value.
The best time to operate for children with Act IV is from 6 months to 1 year old. Parents need to pay attention to give the child appropriate more water in daily life before surgery, because cyanotic precocious heart disease is due to long-term hypoxia, high hematocrit and blood viscosity, in order to prevent the occurrence of embolism, need to drink more water; also pay attention to timely control of infection; for children with hypoxic episodes, parents need to learn the basic treatment, first of all, take the child’s chest and knee position. Parents should learn the basic treatment for children with hypoxic attacks, firstly, take the child’s chest and knee position, curl the legs against the chest, and ensure the air circulation in the room to make the child as quiet as possible. For children with frequent hypoxic attacks, the operation time should be advanced appropriately.
15.What do I need to pay attention to in my daily life after surgery? What are the dietary requirements?
After discharge from the hospital, the child should not be allowed to overeat because he/she is “hungry”, nor should he/she be “afraid” to eat enough because he/she continues to be fed during the hospitalization. For most of the children, they can basically be given 100% of the intake 5 days after surgery. At the same time, because of the growth needs and weight gain of the children, their meal quantity is gradually increasing, so it is impossible for the doctor to give parents very specific instructions when they are discharged from the hospital, such as how much milk to drink each time and how many times a day to eat. Don’t stay hungry”. They should not eat too much so as not to increase the burden on the heart, but not to fail to meet their basic physiological and growth needs. In addition, we should pay attention to the control of salt intake, such as excessive salt intake, can cause a large amount of water retention in the body, resulting in the child’s edema, liver enlargement, increase the burden on the heart, and in serious cases can lead to heart failure. Some parents blindly believe that their children should eat more fish and meat after surgery to replenish their bodies because they need protein to recover after surgery, but in fact, they should also give their children some fresh foods such as fruits and vegetables to replenish some vitamins. Eat less sweets, because the ratio of protein and fat contained in these sweets differs greatly from the normal needs of children. If too much sweet food is consumed, it is easy to cause indigestion, dry stools, loss of appetite, lack of protein and malnutrition in children, which will inevitably affect recovery. It is not advisable to eat more canned drinks and cold drinks. It is not advisable to blindly take tonic. The best post-operative “tonic” is natural food. Parents just need to follow the above-mentioned principles, pay attention to the meat and vegetables, coarse and fine balance in the child’s daily diet, pay attention to prevent the loss and destruction of nutrients when cooking, and ensure that the three meals a day are full and well eaten, the child will definitely recover as soon as possible.
In addition, post-operative daily life should control the amount of activity appropriately, breathe more fresh air, keep a happy mood, do not scratch the incision, and review regularly after surgery. A follow-up visit to the hospital should be made after 3 months of discharge, and a comprehensive review should be made after one year to let the doctor know the recovery of heart function.
16.Can children participate in sports activities after surgery?
After the surgery, most of the children’s heart load is reduced and they feel relaxed and always want to move around. However, parents must pay attention to avoid more strenuous activities within one month, and a leisurely walk is appropriate, because strenuous activities are not conducive to the recovery of heart function, and shortness of breath during activities may easily lead to postoperative thoracic deformity. Generally speaking, after three months, normal life will be resumed gradually, and some strenuous activities will not be a big problem at that time, but we should gradually increase the amount of activities according to our own body condition. If the child’s heart deformity is satisfactorily corrected, the atrial internal diameter is normal, and the heart function is normal, in this case, the child can gradually resume normal activities for children of the same age, as long as the regular post-operative review shows normal heart function, the child can participate in normal sports after school, as long as they do not receive athlete-like high-intensity training.
17.Can children with precocious heart disease get married and have children after they become adults? Will their offspring definitely suffer from congenital heart disease?
People with congenital heart disease are not significantly different from healthy people after surgery and cure of congenital heart disease, so they can get married and have children when they become adults. Congenital heart disease is not a strictly hereditary disease, and the main causes can be divided into two categories: genetic and environmental. However, there are some patients who are familial, because one of the relatives has congenital heart disease can increase the chance of others to have congenital heart disease, so the best way is to go to the hospital for premarital examination and genetic counseling before marriage. You can also go to a cardiology specialist for tests, such as a color ultrasound of the heart, and listen to your doctor’s advice for genetic counseling based on the type of heart disease you have.
Whether a patient with congenital heart disease can tolerate pregnancy and childbirth depends mainly on the strength of the heart function. Patients with Grade 1 or 2 cardiac insufficiency have little risk of having children; patients with Grade 3 cardiac insufficiency cannot, in principle, become pregnant; if they are patients with Grade 4 cardiac insufficiency, they absolutely cannot have children, and if they become pregnant, the pregnancy should be terminated immediately. The following points should be noted during pregnancy: there should be sufficient rest during pregnancy; anemia should be avoided or treated timely; infection should be prevented; digitalis preparations should be used carefully; anticoagulants should be used carefully, etc.
18.Can I have vaccination before and after surgery?
The purpose of vaccination is to make the body immune to these infectious diseases through immune response by inoculating some kind of vaccine, vaccine or toxoid, etc., so that the chance of infection to these infectious diseases can be avoided or reduced. Vaccination itself does not cause further development of heart malformations, but some reactions of varying severity may occur after certain vaccinations. Generally speaking, local reactions have no effect on heart function, while some systemic reactions (such as fever) may increase the burden on the heart. Therefore, general vaccination is not recommended for children with congenital heart disease who usually have poor heart function, especially for children who have frequent heart failure or are in chronic heart failure. However, children who usually have good heart function and good activity endurance can be vaccinated. For children who are preparing for surgical treatment, it is best to avoid vaccination for 1 month before surgery to prevent adverse reactions caused by the low immunity of the body due to surgical blows.
Children after extracorporeal circulation surgery can resume vaccination after their heart function returns to normal in 3 months after surgery and 1 month after interventional surgery, and children who were not vaccinated as planned before surgery due to heart function and other problems should complete the missing parts according to the vaccination procedure. For children undergoing palliative surgery, if the heart function is still poor after surgery or the heart deformity is still obvious, the decision of whether or not to carry out preventive vaccination should be made on a case-by-case basis.
Therefore, the issue of vaccination for children with congenital heart disease must be analyzed on a case-by-case basis, and the view that no vaccination should be given is not correct. The specific indications can be controlled by the staff of vaccination.
19.What measures can be taken during pregnancy to prevent fetuses from having congenital heart disease?
At present, environmental factors are the main factors causing congenital heart disease in China, and several high-risk factors have been confirmed that may lead to birth defects in newborns: the mother-to-be is over 35 years old; those who have been infected with viruses in early pregnancy, especially rubella virus infection; those who have partial micronutrient deficiency in early pregnancy, especially iodine and folic acid deficiency; those who have been exposed to X-ray rays or harmful substances such as benzene, lead and mercury in early pregnancy. Those who have not used medication under the guidance of doctors in early pregnancy. Therefore, it is especially important to improve environmental factors and do a good job of health care during pregnancy (especially early pregnancy) to prevent the occurrence of congenital heart disease in children. These include: active prevention of rubella, influenza and other rubella viral diseases during pregnancy, especially in early pregnancy, eating more vegetables, taking vitamin supplements, getting pregnant at an appropriate age, not using random medication, regular prenatal checkups, and conducting glucose tolerance screening for pregnant women. Do not touch pets, as bacteria and microorganisms on pets may also cause congenital heart disease in children. The living space of pregnant women should have fresh air and sufficient sunlight, and exposure to radioactive substances is strictly prohibited, so as to avoid working and living in an environment with heavy air pollution; fresh vegetables should be soaked in water several times to reduce residual pesticides; no smoking and no drinking. In addition, if oral folic acid is taken early in pregnancy, it can effectively prevent neural tube malformation, while 35% of congenital heart disease and 15% of other malformations can be avoided.
At present, most people believe that exposure to computers should be minimized in early pregnancy, but there is also a 10-year follow-up survey that shows that the amount of electromagnetic radiation from computers is safe for humans, including pregnant women, and safe for sperm, eggs, fertilized eggs, embryos and fetuses. In reality, individual computer operators miscarriage or birth of abnormal fetus is an accidental phenomenon, can not be “convicted” to the computer.
20.Is there any way to find out if the fetus has precocious heart disease during pregnancy checkup?
Ultrasound during pregnancy can screen for simple congenital heart disease. The best time for fetal echocardiography is from 20 weeks to 28 weeks of pregnancy. Because of the small size of the fetal heart in the early stage, the section does not show well; the influence of acoustic shadowing behind the developing fetal skeleton and the influence of fetal orientation in the late stage all cause the exploration of the fetal heart to be affected.
There are many different types of fetal cardiovascular developmental abnormalities, and although fetal cardiac ultrasonography is developing rapidly with the continuous advancement of diagnostic ultrasound instruments and the accumulation of experience and research by those engaged in this specialty, it is an objective fact that there are still many fetal cardiac abnormalities that cannot be detected prenatally. Pregnant women should have knowledge and understanding of this aspect. It is believed that with the development of medical technology, more diseases will be recognized, the level of fetal ultrasound diagnosis will become higher and higher, and the development in all regions of the country will become more and more popular, and the birth rate of children with prenatal heart disease in China will be strongly controlled.